COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2), 115–155
PHONOLOGICAL SPELLING IN A DAT PATIENT:
THE ROLE OF THE SEGMENTATION SUBSY STEM IN
THE PHONEME-TO-GRAPHEME CONVERSION
Renée Béland
Institut universitaire de gériatrie de Montréal and Université de Montréal, Canada
Monique Bois
Institut universitaire de gériatrie de Montréal, Canada
Xavier Seron
Université Catholique de Louvain, Louvain-la-Neuve, Belgique
Brigitte Damien
Institut universitaire de gériatrie de Montréal, Canada
We are presenting a single-case study of a DAT patient whose writing output is severely impaired while
performance in reading aloud and repetition is almost flawless. The large corpus of errors collected from
written and oral spelling tasks shows two important characteristics: (1) in both tasks, OE relies on the
non-lexical route for spelling and produces “phonologically plausible errors” (PPEs) and
“non-phonologically plausible errors” (NPPEs), and (2) the proportion of NPPEs affecting four phonological features [± voiced], [± nasal], [± continuant], and [± rounded] is higher in written than in oral
spelling. Analysis of PPEs and NPPEs reveals that the proportion of PPEs varies in inverse relation to
the phonological complexity of the stimuli, i.e. fewer PPEs are produced in syllabically complex stimuli.
According to our proposal, OE’s functional lesion is localised in the segmentation subsystem of the
phoneme-to-grapheme conversion mechanism. More specifically, OE suffers from a phonological impairment, that is, a lowered tolerance to syllabic complexity, which is exacerbated in any task, including
phonological spelling, that requires an explicit segmentation of the auditory input form. A second deficit affecting the phonological working memory system is responsible for the production of the single
feature errors. We suggest that the single feature errors are more abundant in written than in oral spelling because OE suffers from a deficit affecting the transfer from abstract graphemic representations to
letter forms without affecting the transfer to letter names.
Requests for reprints should be addressed to Renée Béland, Centre de recherche, Institut universitaire de gériatrie de Montréal,
4565 chemin Queen Mary, Montréal, Québec, Canada H3W 1W5 (Tel: (514) 340-3540; Fax: 340-3548; E-mail: belandr@eoa.
umontreal.ca).
This research was supported by the Conseil de la recherche médicale du Canada Program Grant PG-28, by the Fonds de la recherche en santé du Québec (Grant # 952342)and by the Conseil de la recherche en sciences humaines du Canada (Grant # 410-92-0015).
The first author was supported by a Chercheur Boursier award from FRSQ (Québec).
We thank Bernard Croisile and Raymonde Labrecque for useful comments on the neurological aspects of the case. We are very
grateful to Agnesa Pillon, Brenda Rapp, and anonymous reviewers for useful comments on earlier version of this paper. We also thank
Pauline Morin, Marie-Claude Charland, and Francine Giroux for preparation and analysis of the data.
Ó 1999 Psychology Press Ltd
115
BÉLAND, BOIS, SERON, DAMIEN
INTRODUCTION
We present a detailed single-case study of a patient
with dementia of the Alzheimer’s type (DAT)
whose language deficits show two dissociations. A
first dissociation affects speech and writing output.
OE’s oral speech production in both reading aloud
and repetition is almost flawless for words and
nonwords, whereas oral and written spelling are
both severely impaired for word and nonword stimuli. The second dissociation has a bearing on the error pattern observed in written and oral spelling. In
both oral and written spelling the patient resorts to
“phonological spelling”, that is, he produces “phonologically plausible errors” (PPEs) because the
sound correspondence of the errors and the target
are homophonous. For instance, the word tapis
/tapis/ ‘carpet’, written as “tapi” or orally spelled as
T-A-P-I, is categorised as a PPE, whereas a written
spelling error such as “dapi” in response to the same
stimulus is categorised as an NPPE, that is, a
“non-phonologically plausible error”, because the
sound correspondence of “dapi” /dapi/ and that of
1
the target /tapi/ are not homophonous . The patient produced about the same number of PPEs and
NPPEs in both spelling tasks, but the NPPEs display different patterns in the two tasks. In both
word and nonword stimuli, the proportion of
NPPEs affecting four phonological features
([± voiced],
[± nasal],
[± continuant]
and
[± rounded]) is significantly higher in written than
in oral spelling.
The performance of our patient in oral and written spelling is puzzling for two reasons. First, as will
be shown, actual functional architectures for lexical
processing do not easily account for the dissociation
between written and oral spelling with respect to
phonological single feature errors. Second, the percentage of NPPEs varies according to the phonological complexity of the stimulus—a finding that,
to the best of our knowledge, has never been re1
ported. Before presenting the case history, we will
review dissociations between oral and written spelling documented in literature.
Dissociation between Oral and Written
Spelling
A double dissociation between oral and written
spelling has been documented in a few case studies.
Bub and Kertesz (1982) reported a case showing a
better performance in written than in oral spelling
but the analysis was conducted on a very small set of
spelling errors (a total of five errors out of six stimuli). Based on a much larger data set, Goodman and
Caramazza (1986) reported a contrastive error pattern distribution for oral and written spelling.
Their patient produced PPEs and NPPEs in written spelling, but in oral spelling, he produced PPEs
only. They interpreted this dissociation as reflecting damage to the allographic conversion system.
Lesser (1990) reported a brain-damaged patient
with superior oral to written spelling. She proposed
a modification to Margolin’s (1984) functional architecture for spelling to dictation to account for
patient CS’s performance who “demonstrated surface dysgraphia in oral spelling, but phonological
dysgraphia in written spelling” (Lesser, 1990, p.
362). In Lesser’s model, the nonlexical route for
oral spelling is more direct that the lexical route because the heard phonemic string (e.g. cat /kæt/) is
directly converted into a letter name string (cat
/si:eI ti:/) through a “phoneme-to-letter conversion” system. Lesser proposed that her patient CS
was relying more on this direct route for oral spelling resulting in the production of PPEs in oral
spelling and NPPEs in written spelling. As will be
substantiated in this study, none of the previous
proposals easily account for OE’s dissociation between oral and written spelling, which affects the
pattern of NPPEs produced in both spelling tasks.
From now on, the written form of the French word targets are in italic tapis, followed by the IPA transcription within slashes
/tapi/ and translation within single quotation marks ‘carpet’. The patient’s response in oral spelling is indicated by capital letters
T-A-P-I, each letter corresponding to a French letter name. The patient’s response in written spelling are indicated within double quotation marks “dapi”. Finally, IPA transcriptions within square brackets correspond to the patient’s response in tasks requiring an oral
output (e.g. reading aloud of isolated letters: L ® [el]; nonword repetition /baZo/ ® [baSo]).
116
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
The organisation of the paper is as follows. First,
we report the case history, including the neurological and neuropsychological examination. In the
Methodology section, we describe the word and
nonword stimuli sets that were used in the spelling
to dictation testing. The Results section is divided
into four parts. In the first, the patient’s results in
repetition, reading aloud, and copying are reported.
It is shown that the patient’s performance is almost
flawless in these tasks, whereas the percentage of
errors in both the oral and the written spelling task
is higher than 50%. In the second part, analysis of
errors in written and oral spelling reveals similarities and dissimilarities that call into question the origin of OE’s spelling errors. The third part is
devoted to localising OE’s functional lesions,
which force him to rely on the nonlexical route for
spelling. In addition to the deficit affecting the access to the orthographic output lexicon, a deficit affecting a subsystem of the phoneme-to-grapheme
conversion mechanism is proposed to account for
the phonological complexity effect, that is, the
higher rate of NPPEs than PPEs on phonologically
complex stimuli. Two additional deficits, one affecting the working memory system and another affecting the allographic conversion, are proposed to
account for OE’s difficulty in handling phonological features that selectively affect written spelling.
Finally, in the Discussion we compare OE’s performance to that of other phonological spellers described in the literature. We argue that the
phonological complexity effect provides evidence
for the existence of a segmentation subcomponent
in the phoneme-to-grapheme conversion mechanism, and that the syllable may constitute a privileged segmentation unit in French.
CASE HISTORY
The patient is a right-handed native speaker of
French. OE, who is university educated, was 63
years old at the time of testing and had been retired
for 3 years. Before his retirement, he occupied different posts in archaeology, real estate, and administration. The patient is suffering from a
degenerative disease and, according to his wife, be-
gan to display symptoms 2 years earlier. A CT-scan
in 1993 revealed a left temporal atrophy with enlargement of the left temporal horn (see Fig. 1).
According to McKhann et al.’s (1984) criteria,
the actual diagnosis is Probable Alzheimer Disease.
Neuropsychological Testing
Neuropsychological tests revealed impairments of
verbal and nonverbal memory, and praxis. The span
for numbers in auditory presentation was poor
(span = 4). Nonverbal IQ was 95. On the Complex
Figure of Rey, the patient scored 30/36 in copy and
11/36 in delayed recall. These scores are within
2 SDs of the mean scores for an age control group
(copy: mean = 33.2, SD = 2.1; delayed recall:
mean = 22.5, SD = 6.0) (Berry, Allen, & Schmitt,
1991). On the Corsi test, OE obtained a score of 5,
which stands within 1 SD of the age control group’s
mean (mean = 5.49, SD = 1.15) (see Joanette,
Poissant, & Valdois, 1989).
The score for the line orientation judgement test
(Benton, Hamsher, Varney, & Spreen, 1983;
Benton, Varney, & Hamsher, 1978) was 51/60, i.e.
above the cut-off score according to the normative
data (Benton et al., 1983). The clock drawing test
was normal.
Language Evaluation
Language testing was conducted in July 1993 with
the MT-86 b aphasia battery (Nespoulous et al.,
1992). Scores on the following subtests: object
manipulation under verbal request, dictation, oral
picture naming, written picture naming, verbal fluency, oral picture description and buccofacial praxis
(verbal request) (see Appendix A) were lower than
cut-off scores of the Age × Education control
group (Béland & Lecours, 1990; Béland, Lecours,
Giroux, & Bois, 1993). OE showed a severe picture-naming deficit and difficulties in both spontaneous writing and writing to dictation. His written
output contained different types of spelling errors:
(1) PPEs (e.g. antiquité /ãtikite/ ‘antiquity’ ®
“entiquité”); (2) NPPEs affecting a phonological
feature (e.g. télévision /televizjO
~ /‘television’ ®
“téléphision” /telefizjO
~ /). Single feature errors, such
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
117
BÉLAND, BOIS, SERON, DAMIEN
Fig. 1. CT scan of patient OE showing a left temporal atrophy
with enlargement of the left temporal horn.
as /v/ becoming /f/ in the word télévision /televizjO~ /,
were marked, and seemed to arise in written spelling only.
At first, we examined the possibility that this
dysorthographia was premorbid. The patient himself reported—and this was confirmed by his family—that he suffered from dysorthographia in
childhood, from which he recovered at the end of
elementary school. This recovery is confirmed by
the analysis of samples of his diary written at the age
of 14 and later at age 39 (Fig. 2), as well as handwritten letters which contain no single feature errors. Spelling errors found in premorbid samples
corresponded to past participle agreement in gender or/and number (e.g. the past participle of the
verb toucher ‘affect’ in the sentence sont très touchés
was written without the final “s”).
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
This peculiar aspect of the voicing errors in written spelling led us to undertake a meticulous investigation of the patient’s language deficit, testing the
difficulties input and output modalities.
METHODOLOGY
Phonological feature errors in the patient’s writing
output might result from a deficit in processing the
input phonological information. Previous work on
phonemic paraphasias in oral production (Béland,
Caplan & Nespoulous, 1990; Béland, Paradis, &
Bois, 1993; Béland & Valdois, 1989) indicated that
the best predictors of the distribution of phonemic
errors lie within the phonological characteristics of
the stimuli. We therefore constructed lists of stimuli controlled for their phonological complexity.
We designed four lists of word and nonword stimuli, and distinguished two types of stimuli. List 1
included 168 phonologically simple word stimuli
PHONOLOGICAL SPELLING IN A DAT PATIENT
Fig. 2. Two samples of OE’s premorbid handwriting taken from his diary.
Translation of the March 1944 sample:
Today is much colder than yesterday. Snow had nevertheless melted a bit. From 3h30 to 5h00 Father ... had shown me how his
kodak works. He promised me to continue on tomorrow.
Translation of the March 1969 sample:
I bathed him around 10h00 after his porridge and his bottle we clothed him to go for dinner at ... He slept until 14h00. After he
had eaten carrots and pears and his bottle he would not fall asleep and would seem to suffer from colics and cramps. At 4h30 we ...
that were mainly bisyllabic, comprising two onset-rime syllables, i.e. the universally unmarked syllabic structure CV (Kaye & Lowenstamm, 1981);
e.g. tapis /tapi/ ‘carpet’, bateau /bato/ ‘boat’. In addition, simple stimuli respected the following segmental constraints: (1) they did not comprise two
nondental segments (e.g. café /kafe/ ‘coffee’); (2)
they did not comprise two identical consonants
(e.g. dindon /dE
~ dO
~ / ‘turkey’); and (3) they did not
comprise two consonants sharing the same place of
articulation (e.g. méfait /mefE/ ‘damage’ in which
/m/ and /f/ are both labial consonants).
List 2 was made up of 277 phonologically complex word stimuli that generally included only one
marked phonological context2, i.e., a context which
is less frequent in world languages (see LaCharité &
Paradis, 1993, for the integration of markedness in
multilinear phonology. This set was more elaborate
than the first one, in that it was divided into 13 different subsets (see Appendix B) representing vari-
2
A small number of complex word stimuli (6%) comprised more than one marked (complex) phonological context, because it was
not always possible to find a word in French which would also respect other nonphonological criteria such as word lexical frequency,
number of syllables, or graphemes. For instance, the word stimulus obéis /obei/ ‘obey’ comprises two complex contexts: a word initial
syllable /o/ and a word-final syllable /i/, both displaying an empty onset position.
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
119
BÉLAND, BOIS, SERON, DAMIEN
ous kinds of complex contexts that were determined
in previous studies on a patient suffering from progressive phonological deterioration (Béland &
Paradis, 1993a, b, 1996, 1997). All these contexts,
which are found in well-formed French words, respect the universal and language-specific phonological constraints, but each one is forbidden in one
or several world languages.
List 3 contained a set of 54 stimuli controlled for
their frequency and orthographic structure
(Croisile, Adeleine, Carmoi, Aimard, & Trillet,
1995). The stimuli were all nouns categorised as
ambiguous (e.g. éléphant /elefã/ ‘elephant’), regular
(e.g. montagne /mO
~ ta® / ‘mountain’), and irregular
(e.g. femme /fam/ ‘woman’) following criteria established for writing words to dictation by Beauvois
and Dérouesné (1981). Finally, List 4 included 60
nonword stimuli (36 syllabically complex and 24
syllabically simple stimuli).
Stimuli from List 1 (phonologically simple) and
List 2 (phonologically complex) were matched for
3
mean lexical frequency [t(247) = –1.43, P > .05]
and mean number of syllables [t(439) = –0.031,
4
P > .05] as indicated in Table 1. However, there is
a tendency for complex stimuli to be longer than
simple stimuli in a number of phonemes
[t(439) = 5.76, P < .01] and a number of letters
[t(439) = 7.89, P < .01]. Simple and complex stimuli were also controlled for phoneme distribution,
Table 1. Mean Number of Syllables, Letters, and Phonemes for
Phonologically Complex and Simple Stimuli
Syllables
Letters
Phonemes
Complex Stimuli
N = 273
Simple Stimuli
N = 168
2.01
6.21
4.59
2.01
5.22
4.03
3
that is, the relative frequency of each phoneme
/p,b,m,t,d,n,../ in both stimuli sets was similar and
this was confirmed by a Kolmogorov-Smirnov test,
which revealed no difference at a .05 level of
significance.
RESULTS
Dissociation between Spelling and Other
Language Tests
A list of 100 stimuli (35 phonologically simple word
stimuli from List 1, 35 phonologically complex
word stimuli from List 2, and 30 nonwords from
List 4 [15 simple and 15 complex]) was administered in 5 tasks between September 1993 and January 1994. Analysis of the patient’s performance
revealed the following error distribution: repetition = 0%, reading aloud = 5% (3 errors in words
and 2 in nonwords), copying = 4% (1 error in words
and 3 in nonwords), written spelling = 54% (40 errors in words and 14 in nonwords), and oral spelling = 42% (31 errors in words and 9 in nonwords).
The difference in percentage of errors in the differ2
ent tasks is significant [c (4) = 152, P < .001)].
These results revealed a first dissociation between
repetition, reading aloud, and copying on the one
hand, and between oral and written spelling on the
other. A more extensive testing was undertaken to
assess more specifically the patient’s performance in
written and oral spelling.
Written and Oral Spelling to Dictation
Methodology
A set of 500 stimuli, composed of 168 simple word
5
stimuli (List 1), 272 complex word stimuli (List 2)
Lexical frequencies are taken from Baudot (1990). We compared the mean lexical frequency only for stimuli for which a lexical
frequency value was available in Baudot (1990). The analysis was thus conducted on a total of 249 stimuli: 138 complex and 111 simple.
4
The total number of stimuli in this analysis is 441 (168 simple stimuli and 273 complex stimuli) rather than 445 (168 simple and
277 complex stimuli) because four complex stimuli were ambiguous with respect to their number of phonemes (e.g. cuiller ‘spoon’ pronounced either as ‘kèij er] = 6 phonemes or [kYjer] = 5 phonemes) or syllables (e.g. embuer ‘to mist up’ pronounced either as a bisyllabic
[ãbèe] or as a trisyllabic word [ãbYe]).
5
The total is 272 rather than 277 because 5 stimuli of List 2 were not administered in both spelling tasks and were, therefore, taken
out of all anlayses.
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
and 60 nonword stimuli (24 simple and 36 complex
from List 4), was administered in both spelling
tasks. Stimuli were randomly assigned to oral and
written spelling tasks in order to ensure that the
same stimulus was not tested in both tasks within
one testing session. The testing required 20 different sessions between October 1993 and January
1994. Analysis of the spelling errors in the two
spelling tasks revealed a number of similarities and
dissimilarities. In the following, we first report on
the similarities found in the error pattern of the two
tasks. Then we describe the three characteristics
that were not common to the error pattern of the
two spelling tasks.
Error Pattern Similarities in Written and Oral
Spelling
Error Rate.
1. Word stimuli. The patient produced a high
proportion of errors in written spelling
(316/440 = 71.8%) and oral spelling (289/440 =
66%) and the difference in error percentages is not
significant (c2 with continuity correction = 3.6,
P > .05). OE’s responses were highly inconsistent
in the two spelling tasks: 25% (42/168) of the phonologically simple stimuli (e.g. melon ‘melon’, malin
‘smart’) and 13.2% (36/272) of the phonologically
complex stimuli (e.g. prison ‘jail’, épi ‘ear’) were
correctly spelled in both written and oral spelling.
A higher proportion of simple stimuli (72/168
= 42.8%) and complex stimuli (169/272 = 62.1%)
were misspelled in both tasks (e.g. judo /ZYdo/ ‘judo’
is written “judeau’ and orally spelled J-U-D-O-T;
épais /epE/ ‘thick’ is written “épai” and orally spelled
É-P-E-T). Finally, a low proportion of simple
stimuli (17/168 = 10.1%) and complex stimuli
(30/272 = 11%) were correct in written spelling but
orally misspelled (e.g. valet /vale/ ‘valet’ is written
“valet” but orally spelled V-A-L-A-I). Conversely,
37 of the simple stimuli (37/168 = 22%) and 37 of
the complex stimuli (37/272 = 13.6%) were misspelled in writing but correctly spelled orally (e.g.
palais /pale/ ‘palace’ was written “palait”, but orally
spelled as P-A-L-A-I-S). This lack of consistency
ruled out the possibility that OE could orally spell a
subset of words that he could not write to dictation,
and conversely, that he could write to dictation
words that he could not orally spell.
2. Nonword-stimuli. OE produced a total of 37
errors on nonword stimuli in written spelling to
dictation 37/60 = 62%) and 30 errors in oral spelling to dictation (30/60 = 50%). The difference in
error percentages between written and oral spelling
2
is not significant (c with continuity correction = .27, P > .05).
Phonological Complexity Effect. OE produced
both PPEs and NPPEs in written and oral spelling
(see Appendix C for examples). In this analysis, we
examine the distribution of the two error types
(PPEs and NPPEs) according to the phonological
complexity of the stimuli (simple vs. complex).
1. Results for word stimuli: simple vs. complex.
Among the total 316 errors produced in written
spelling on word stimuli, 108 were on simple stimuli and 208 on complex stimuli. The patient produced about the same number of PPEs
(55/108 = 50.93%) and NPPEs (53/108 = 49.07%)
on simple stimuli, but a much higher proportion of
NPPEs (174/208 = 83.6%) than PPEs (34/208
= 16.35%) on complex stimuli. Under oral spelling
conditions, from the total 289 errors, 88 were produced on simple stimuli and 201 on complex stimuli. OE produced more PPEs (53/88 = 60.23%)
than NPPEs (35/88 = 39.77%) on simple stimuli,
and more NPPEs (157/201 = 78.11%) than PPEs
(44/201 = 21.89%) on complex stimuli. The difference in the distribution of PPEs and NPPEs for
simple versus complex stimuli is significant, both in
written spelling (c2 with continuity correction = 40.32, P < .001) and oral spelling (c2 with
continuity correction = 38.64, P < .001) and oral
spelling (c2 with continuity correction = 38.64,
P < .001).
A difference in the frequency for soundto-spelling correspondences between simple and
complex stimuli could be responsible for this effect.
In order to ascertain that the phonological complexity effect was not influenced by word lexical
frequency and/or the frequency of the sound-tospelling correspondences, the same analysis was
conducted on the 249 stimuli (111 simple and 138
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
121
BÉLAND, BOIS, SERON, DAMIEN
complex) matched for lexical frequency (see footnote 3).
First, the frequency of the sound-to-spelling
correspondences of simple and complex stimuli
was calculated using two frequency tables (Content & Radeau, 1988; Véronis, 1986). Results indicate no significant difference in the mean
frequency of sound-to-spelling correspondences
between simple and complex stimuli according to
Content and Radeau’s table [t(1020) = 1.75,
P > .05]. However, a significant difference for the
mean number of letters [t(247) = 6.37, P < .001]
and of phonemes [t(247) = 6.22, P < .001] was
present. Simple stimuli were slightly shorter for
mean number of letters (mean = 5.26 letters) than
complex stimuli (mean = 6.15 letters). They were
also shorter for mean number of phonemes
(mean = 3.84 phonemes) than were complex stimuli (mean = 4.62 phonemes). However, the difference between simple and complex stimuli with
respect to the number of syllables was not significant [t(247) = 1.1, P > .05]. In this 249 stimuli
subset, in the written spelling condition, the patient produced 174 errors, 103 of which were on
complex stimuli and 71 on simple stimuli. He pro-
duced about the same number of PPEs (37/71 =
52.1%) and NPPEs (34/71 = 47.8%) on simple
stimuli, but a much higher proportion of NPPEs
(86/103 = 83.5%) than PPEs (17/103 = 16.5%) on
complex stimuli.
In the oral spelling task, a total of 150 errors were
produced, 54 of which were on simple stimuli and
96 on complex stimuli. OE produced more PPEs
(34/54 = 63%) than NPPEs (20/54 = 37%) on simple stimuli, and more NPPEs (77/96 = 80.2%) than
PPEs (19/96 = 19.8%) on complex stimuli. As illustrated in Fig. 3, the difference in the distribution
of PPEs and NPPEs on simple versus complex
2
stimuli is significant both in written spelling (c
with continuity correction = 23.26, P < .001) and
2
oral spelling (c with continuity correction = 26.33,
P < .001). Therefore, the phonological complexity
effect remained even when the stimuli were controlled for their lexical frequency and the frequency
of their sound-to-spelling correspondences.
2. Results in nonword stimuli: simple vs. complex. In contrast with word stimuli, for which we
distinguished three possible spelling responses (a
correct response, a PPE, and a NPPE), in nonword
stimuli there were only two possible responses: a
Fig. 3. Percentage of PPEs and NPPEs for 111 phonologically simple and 138 complex stimuli matched for lexical frequency and frequency
of sound-to-spelling correspondences in written and oral spelling.
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
NPPE or a PPR, that is, a “phonologically plausible
response” because nonwords have no permanent
orthographic representations. The analysis for the
phonological complexity effect was thus conducted
on the comparison of the proportion of NPPEs and
PPRs produced on simple and complex nonword
stimuli. In written spelling, OE produced 14
NPPEs (14/24 = 58%) and 10 PPRs (10/24 = 42%)
on phonologically simple nonword stimuli. On
phonologically complex nonword stimuli, he made
23 NPPEs (23/36 = 64%) and 13 PPRs
(13/36 = 36%). In oral spelling, OE produced 9
NPPEs (9/24 = 38%) and 15 PPRs (15/24 = 62%)
on phonologically simple nonword stimuli,
whereas on phonologically complex nonword stimuli he produced 21 NPPEs (21/36 = 58%) and 15
(15/36 = 42%) PPRs. In contrast with word stimuli, the difference in the distribution of PPEs and
PPRs for simple versus complex nonword stimuli
does not reach the level of significance either in
2
written spelling (c with continuity correc2
tion = .03, P > .05) or in oral spelling (c with continuity correction = 1.7, P > .05). However, this
finding should be interpreted cautiously because
the number of nonword stimuli is much lower than
the number of word stimuli. The distribution of
correct responses, PPEs, NPPEs and PPRs for
word and nonword stimuli is given in Table 2.
Variability and Frequency Effects in Sound-toSpelling Correspondences. French has a very
opaque orthography, that is, same sounds have
many possible sound-to-spelling correspondences.
For instance, the phoneme /o/ has at least 20 different sound-to-spelling correspondences (o, os, ot,
oc, op, ô, ôt, au, aux, eau, eaux, aut, auts, aud, auds,
ho, hô, haut, heau, ault). The frequency of each of
these spelling correspondences varies according to
the position of the syllable (word-initial, wordmedial, or word-final). For instance, according to
the Brulex database for French (Content &
Radeau, 1988), the most frequent spelling correspondence of the sound /o/ is “au” in word-initial
position, and “o” in word-final position. It is thus
very difficult for a French speaker to guess what the
most frequent sound-to-spelling correspondence
Table 2. Distribution of Correct Responses, PPEs, NPPEs, and
PPRs in Written and Oral Spelling for Word and Nonword
Stimuli
Written Spelling
No
%
Word stimuli (N = 440)
Correct responses
PPEs
NPPEs
Nonword stimuli (N = 60)
PPRs
NPPEs
Oral Spelling
No
%
124
89
227
28%
20%
52%
151
97
192
34%
22%
44%
23
37
38%
62%
30
30
50%
50%
of a particular sound in a specific word position is.
Note that French speakers might, however, have an
implicit knowledge of the sound-to-spelling correspondence frequencies.
In this analysis, the sound-to-spelling correspondences chosen by the patient in the PPEs he
produced in oral and written spelling were examined both for variability and for frequency effects.
Different examples of the patient’s spelling, which
exhibits many sound-to-spelling correspondences
for the same sound, are listed in Appendix C. As
can be noticed, the patient’s conversions are in accordance with the variability found in French
orthography.
In order to underscore a frequency effect in OE’s
selection of sound-to-spelling correspondences, we
performed an ANOVA with the factors Corpus
(input letters, output letters) and Task (written
spelling, oral spelling) on a subset of the PPEs produced with phonologically simple stimuli (N = 57
errors in written spelling, N = 55 errors in oral
spelling). The analysis was conducted on phonologically simple stimuli only because it was important to separate out the frequency effect in the
selection of the phoneme-to-grapheme correspondence from the phonological complexity effect. For
every PPE, the input value corresponded to the frequency of the letter(s) according to its/their position in the word. For example, judo /ZYdo/ ‘judo’ ®
“judot”, the input value is the frequency of the letter
“o” in fourth position in a four-letter word, i.e. 3118
(see Content and Radeau, 1988, for explanations
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
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BÉLAND, BOIS, SERON, DAMIEN
6
on how the calculations were done) . The output
value is the frequency of the patient’s erroneous
sound-to-spelling correspondence, “ot”, in final
position, i.e. 474. For this example, the erroneous
mapping “ot” is thus less frequent than the letter of
the input word stimulus “o”.
Results of the ANOVA revealed a significant effect for Corpus [F(1,110 = 4.90, P < .05] with no
significant interaction. In both tasks, the mean frequency value of the patient’s mapping (output) was
higher than the mean frequency value of the letter(s) in the stimulus (input).
In summary, the functioning of the phoneme-to-grapheme conversion mechanism in our
patient’s production of PPEs was in keeping with
the variability of the French orthography and
showed a frequency effect in the selection of the
sound-to-spelling correspondences, both in oral
and written spelling.
Phonological Repairs. A number of NPPEs produced by the patient on phonologically complex
stimuli in both oral and written spelling correspond
to “phonological repairs” that is, spelling errors that
contained feature, vowel, or consonant insertions
that reduced the syllable complexity at a phonological level (e.g. poète /poet/ ‘poet’ ® “polète”). The
notion of phonological repairs in aphasic speech
was described in several case studies (Béland et al.,
1990; Béland & Paradis, 1993a, b, 1996, 1997) and
in a group study (Béland, Paradis, et al. 1993) to account for phonemic paraphasias. In this study, we
use this concept for the first time to describe spelling errors that are phonologically principled at a
syllabic level. The phonological repair occurring on
the word stimulus pays /pei/ ‘country’ ® “pailis” is
illustrated in Fig. 4. In this example, the problematic syllabic context for the segmentation lies in the
presence of an empty onset on the syllabic tier.
The presence of an empty onset within a word
(i.e. hiatus) constitutes a marked context that is for6
bidden in may world languages. The phonological
repair that was applied in this context consists of a
consonant insertion, which fills in the empty onset.
Such a repair respects the Preservation Principle
(Béland & Paradis, 1996, 1997; Paradis & La
Charité, 1997), according to which, in this syllabic
context, consonant insertion must be preferred to
vowel deletion. Once the phonological repair is applied, the second step consists of phoneme-to-grapheme inversion. As illustrated in Fig.
4, OE’s mapping of the phonemes in the phonemic
paraphasia was the following: /p/ ® “p”, /e/ ® “ai”,
/l/ ® “l” and /i/ ® “is”.
The Preservation Principle is violated when the
applied repair strategy involves the loss of segmental information. For instance, the patient produced
the following error in oral spelling: échéant /eSeã/
‘due’ ® E-C-H-A-N. The problematic context in
this target is the presence of an empty onset between the two vowels (/e/ and /ã/). According to
the Preservation Principle, the expected repair
would be a consonant insertion between the two
vowels and not the loss of a vowel. Among the 64
examples of phonological repairs collected in written spelling and the 74 examples collected in oral
spelling, the rate of segment preservation is very
high, i.e. 85.7% (118/138).
To summarise, OE produced about the same
number of phonological repairs in written and oral
spelling. Analysis of the NPPEs categorised as
“phonological repairs” reveals a very high rate of
segment preservation as opposed to segment deletion in both spelling tasks.
Miscellaneous Errors. The patient produced 42
NPPEs in written spelling (42/316 = 13%) and 42
NPPEs in oral spelling (42/289 = 14%) on word
stimuli for which we have no explanations. Examples of these errors are listed in Appendix C. They
involve letter additions (e.g. in oral spelling:
nonword /vais/ ® VAIVSE) or complex errors
The manner in which phoneme-to-grapheme frequency is computed allows us to take into account the characteristics of the word
targets, that is, to make a distinction between two words including the same sound, for instance /o/, spelled differently: e.g. judo /ZYdo/
‘judo’ and cadeau /kado/ ‘gift’. Using this method, a same phoneme-to-grapheme correspondence, e.g. “ot” in the patient’s responses,
receives a different value depending on the word target. This computing method allows us to compare the patient’s spelling output
given a specific input.
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
Fig. 4. A phonological repair applied on the word stimulus pays
/pei/ ‘country’ ® pailis.
(e.g. in written spelling: toucan /tukã/ ‘toucan’ ®
“tougert”).
Error Pattern Dissimilarities in Written and Oral
Spelling
Tortuous Spelling Errors. Hatfield and Patterson
(1983, p. 461) categorised as “tortuous” errors those
which “require a more tortuous post hoc account”.
A good example reported by these authors is the
word “quiet” /k@-wai-@t/ spelled “ceyet”, where the
sound /k@/ was spelled “ce” (“c” is a common spelling for /k/ in English); /wai/ was spelled “y” (name
of letter) and /@t/ ® et. OE produced such letter-name errors in oral spelling only. For instance,
he orally spelled flairer /flere/ ‘to scent’ ®
F-L-R-É, omitting the sound-to-spelling correspondence for /e/, a sound which is included in the
letter-name /er/ of “R”. We also categorised
geminate letter errors involving the letter “s” (e.g.
vaisseau /veso/ ‘vessel’ ® “vaiseau”) as tortuous errors because, strictly speaking, the sound corre7
spondence of an intervocalic “s” is /z/ in French .
Geminate errors, found in both oral and written
spelling, differ from PPEs such as ballon /balO
~ / ‘ball’
® “balon” since the sound /l/ can be spelled with
one or two “l”s without changing the sound correspondence. The remaining tortuous errors were errors like poète /poet)/ ‘poet’ ® “poheit”, that is,
phonologically plausible transcription of the word
containing unattested sound-to-spelling correspondences (in this example “heit” is unattested in
French).
7
There are only a few exceptions where the letter S is pronounced /s/ (e.g. parasol /parasOl/ ‘umbrella’, cosinus /kOsinYs/ ‘cosine’,
vraisemblable /vrEsãblabl / ‘likely’, aseptique /asEptik/ ‘aseptic’, and contresens /kO
~ trûsa~s/ ‘misinterpretation’).
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
125
BÉLAND, BOIS, SERON, DAMIEN
A total of 28 tortuous errors were collected in
written spelling, (0 letter name errors, 6 geminate
errors, and 22 unattested sound-to-spelling correspondences), whereas a total of 56 were collected in
oral spelling (9 letter name errors, 6 geminate errors, 41 unattested sound-to-spelling correspondences). All tortuous errors were phonologically
principled, that is, they resulted from the relying
onto the nonlexical route for spelling (see Appendix
C for examples).
Spelling Errors Affecting French Accents. Some errors would be PPEs had they not involved an omitted accent or one that was erroneously added on
occasion. These errors found in both oral and written spelling were much more frequent in oral spelling (N = 25) than in written spelling (N = 3) (see
Appendix C for examples).
Single Feature Errors. Among the 264 NPPEs
produced in written spelling (227 in word stimuli +
37 in nonword stimuli), we counted 187 phonological single feature substitutions. A single feature
substitution is a substitution in which the substitute
and the substituted segment share all phonological
features but one. For instance, the sound /b/ written
as “p” or orally spelled as /pe/, is a single feature substitution ([+ voiced] ® ([- voiced]) whereas the
sound /b/ written as “t” is not categorised as a single
feature error because such a substitution involves
more than one feature. In oral spelling, among the
222 NPPEs (192 in word stimuli + 30 in nonword
stimuli), we counted only 53 single feature errors.
Since some NPPEs contain more than one single
feature error (e.g. vanité /vanite/ ‘vanity’ ®
“fanider”, which contains two errors involving the
voicing feature), the number of single feature errors
outnumbers the number of stimuli. The 187 errors
in written spelling occurred on 127 different stimuli
and the 53 single feature errors in oral spelling occurred on 25 different stimuli8. Note that most, but
not all, of the single feature errors were found in examples such as vanité /vanite/ ‘vanity’ ® “fanider”,
that is, in NPPEs which contain single feature er8
rors only. Single feature errors were also found in a
few NPPEs categorised as rapairs and tortuous
spelling errors (e.g. vaillant /vajã/ ‘valiant’ ®
“faibant” in which the word-initial labial voiced fricative /v/ is replaced by the unvoiced labial fricative
/f/).
Given that the same 440 stimulus set was administered in both tasks, the probability of occurrence of a single feature error is the same in both
tasks. The difference in the error pattern of the two
tasks deserves a closer investigation. As shown in
Table 3, a dissociation is observed between oral and
written spelling for four different phonological
features:
1. Errors affecting the features [± voiced] are
10 times more frequent in written spelling
than in oral spelling. Only 11 voicing errors
were collected in oral spelling, whereas 103
voicing errors were produced in written
spelling.
2. Errors affecting the features [± nasal] for vocalic and consonantal segments were more
frequent in written spelling (N = 37) than in
oral spelling (N = 24).
3. Errors affecting the features [± continuant]
were found only in written spelling (N = 12).
4. Errors affecting the features [± rounded]
were twice as numerous in written spelling
Table 3. Distribution of Errors Affecting the Four Phonological
Features in Written and Oral Spelling
Phonological Feature
Substitutions
No. of Errors
———————–———————
Written Spelling
Oral Spelling
a
Voiced
Nasal
Continuant
Rounded
103
37
12
35
11
24
0
18
Total
187
53
a
Numbers represent total feature substitutions which may
occur more than once within a stimulus. Feature errors were
collected from 127 stimuli in written spelling and 25 in oral
spelling.
This is the only anlaysis in which more than one error is counted if a word has more than one error. In all remaining analyses, one
error means one stimulus incorrectly produced.
126
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
(N = 35) as in oral spelling (N = 18), all consisting of substitutions of the vowel /a/ for
/o/, or /o/ for /a/.
There is a significant difference between the distribution of errors for the four features produced in
oral and written spelling [c2(3) = 28.6, P < .001].
Table 4 shows that the substitutions of the features
[± voiced], [± nasal], and [± rounded] occurred in
both directions, that is, from + to – and from – to +,
whereas for the features [± continuant], all substitutions occurred from [+ continuant] to
[– continuant] (see Appendix C for examples of the
different single feature substitutions). The dissociation in the number of single feature errors is found
also for nonword stimuli, with the same stimuli sets
used in oral and written spelling.
and oral spelling tasks. The similarities, i.e. characteristics that were common to both spelling tasks,
were: (1) a high error rate (³ 50%); (2) a significant
phonological complexity effect; (3) variability and
frequency effects in sound-to-spelling correspondences chosen by the patient; (4) phonological repairs showing a high rate of segment preservation
(> 85%); and (5) the same proportion of miscellaneous errors.
The dissimilarities found in the error pattern of
the two spelling tasks were the following: (1) a
higher number of tortuous spelling errors in oral
spelling than in written spelling; (2) a higher number of accent errors in oral spelling than in written
spelling; (3) a higher number of single feature errors
in written than oral spelling. We examine each of
these dissimilarities in turn.
Summary
A first set of 100 stimuli composed of words and
nonwords was administered to the patient in reading aloud, repetition, copying, and written and oral
spelling to dictation. The patient’s performance
was almost flawless in the first three tasks, whereas
the error rate was higher than 40% in spelling tasks.
A set of 440 words and 60 nonwords was administered to OE in both written and oral spelling to dictation in order to assess more specifically the
patient’s spelling performance. Analysis of the
spelling errors pointed to a number of similarities
and dissimilarities in OE’s error pattern in written
1. Higher number of tortuous errors in oral
spelling. Three subtypes of tortuous errors were
distinguished: letter name errors, geminate errors,
and unattested sound-to-spelling correspondences.
Letter name errors might have arisen when the patient attempted to convert the content of the phonological buffer directly into letter names rather
than converting phonemes into graphemes then
graphemes into letter names. These errors were,
thus, more likely to arise in oral then in written
spelling. An equal number of geminate errors was
found in the two spelling tasks (six in oral spelling
and six in written spelling). Finally, unattested
Table 4. Distribution of Errors Affecting Four Different Phonological Features for Simple, Complex, and Nonword Stimuli in Written
and Oral Spelling
Phonological Features
[+ voiced] ® [– voiced]:
[– voiced] ® [+ voiced]:
[+ continuant] ® [– continuant]:
[– continuant] ® [+ continuant]:
[+ nasal] ® [– nasal]:
[– nasal] ® [+ nasal]:
[+ rounded] ® [– rounded]:
[– rounded] ® [+ rounded]:
Total (240)
Phonologically Simple Stimuli
————————————
Written
Oral
Spelling
Spelling
Phonologically Complex Stimuli
————————————
Written
Oral
Spelling
Spelling
Nonword Stimuli
——————————
Written
Oral
Spelling
Spelling
10/26
16/26
0
0
5/11
6/11
6/7
1/7
2/2
0
0
0
2/5
3/5
1/6
5/6
23/53
30/53
5/5
0
9/23
14/23
14/22
8/22
3/8
5/8
0
0
9/11
2/11
10/10
0
13/24
11/24
7/7
0
0
3/3
4/6
2/6
0
1/1
0
0
5/8
3/8
0
2/2
44
13
103
29
40
11
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
127
BÉLAND, BOIS, SERON, DAMIEN
sound-to-spelling correspondences were more frequent in oral spelling (N = 41) than in written spelling (N = 22). We have no explanation for the
higher rate of unattested sound-to-spelling correspondences in oral spelling.
2. Higher number of accent errors in oral spelling. The higher proportion of accent errors in oral
spelling is not surprising because accents are not always produced in normal oral spelling.
3. A higher number of single feature errors in
written spelling, which constitutes the main focus
of upcoming analyses, confirms our initial impression that single feature errors were more frequent in
written than in oral spelling.
Two important dissociations have been identified so far in this case study. The first one is between
unimpaired repetition, reading aloud, and copying
on the one hand, and severely impaired oral and
written spelling on the other hand. The second dissociation is characterised by the significantly higher
proportion of NPPEs comprising single feature
substitutions in written than in oral spelling.
In the following, we will attempt to localise the
patient’s functional lesions that best account for
these two dissociations. More specifically, we will
attempt to explain: (1) how single feature errors
may occur in spelling without occurring in repetition and oral reading, and (2) why these single features errors are more abundant in written than in
oral spelling.
Localisation of the Patient’s Functional
Lesions
Methodology
As the patient was suffering from a degenerative
disease, all the testing was undertaken within the
same 8-month period between September 1993
and April 1994, during which the spelling tests
were administered. In order to localise the patient’s
functional lesions, we will rely on Goodman and
Caramazza’s (1986) architectural model for reading
and writing. This model comprises two input lexi9
cons (phonological and orthographic), two output
lexicons, and two routes (lexical and nonlexical) for
reading and writing. An adaptation of this model is
reproduced in Fig. 5. First, we examine the integrity of the relevant input components: acoustic
analysis, phonological input lexicon, and orthographic input lexicon. Second, we examine the integrity of the semantic system.
Input Components
Acoustic Analysis. The acoustic analysis component constitutes the first input component involved
in the processing of the material presented
auditorily. The integrity of this component was verified by using two tests administered in April 1994.
1. Auditory CV and V syllable discrimination.
The patient was presented with 82 pairs of auditory
stimuli. He was asked to answer if, yes or no, both
members of the pair were identical. Half of the syllable pairs were identical. The test was constructed
to assess the performance of the patient in discriminating all the consonant voicing contrasts (e.g. /pa/
vs. /ba/; /ga/ vs. /ka/), all the consonant nasal contrasts (e.g. /da/ vs. /na/), all the continuant contrasts (e.g. /pa/ vs. /fa/) and the round contrast (e.g.
/a/ vs/ /o/). The patient produced one error.
2. Auditory rhyme judgement. Two types of
rhyming pairs of stimuli were used: rich rhymes, i.e.
word pairs sharing a whole syllable (e.g. paletot
/palto/ ‘overcoat’ and gâteau /gAto/ ‘cake’), and
poor rhymes, i.e. word pairs sharing only the syllable rhyme constituent (the vowel nucleus and the
coda constituent) (e.g. femme /fam/ ‘woman’ and
lame /lam/ ‘blade’). The patient’s performance was
good: OE was correct 88% of the time (7 errors out
of 60 pairs) on poor rhyme stimuli and 92% of the
time (8 errors out of 99 pairs) on rich rhyme
stimuli9.
Results of five controls (three female and two
male) matched for age and educational level (mean
age = 63.2 years, mean education = 18 years) were
close to perfect score on poor rhyme stimuli (mean
score = 59.6/60) and rich rhyme stimuli (mean
score = 98/99).
The 318 word stimuli (60+99 = 159 word pairs) were administered in a task of reading aloud in a separate testing session; all stimuli were correctly read.
128
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
Fig. 5. Functional architecture model for reading and writing (adapted from Goodman & Caramazza, 1986).
Orthographic and Phonological Input Lexicons. Integrity of the orthographic analysis component
does not necessarily imply that the patient correctly
accessed the orthographic input lexicon (OIL). A
deficit involving the OIL and/or its access will result in failure to recognise written word stimuli as
lexical entries. To test the patient’s OIL, we administered a lexical decision task in the visual modality.
The stimuli consisted of 40 words and 40
nonwords. Nonwords were constructed by changing one letter of a word. For instance, the nonword
“parabluie” was obtained by changing the fifth letter of the word parapluie ‘umbrella’. Nonwords were
phonologically identical to words except for one
feature. For instance, in the nonword “parabluie”
the letter “p” is replaced by “b”. The sound correspondence of this letter shares all the features but
the voicing with the sound correspondence of the
substituted letter “p”. The patient produced 11 errors, all consisting of false positives (e.g. the patient
incorrectly identified as a word the nonword
“plason”, differing in a single feature from the word
blason /blazO
~ / ‘blazon’). The same stimuli set was
also used in an auditory lexical decision task to rule
out damage to the phonological input lexicon
(PIL). OE made only two errors. The patient’s
good performance when presented with auditory
stimuli indicates that the PIL (and/or the access to
it) is unimpaired. The patient’s performance in the
lexical decision task is, thus, better in auditory than
in visual input modality.
In order to verify the integrity of the lexical route
from the OIL and the PIL up to the semantic system, we constructed a list comprising 69 animal
names and 65 nonanimal names. Animal and
nonanimal names were mixed and randomly
presented to the patient. OE was requested to
repeat—and, in a different session, to read
aloud—only the animal names, which forced him to
do a minimal semantic analysis. In repetition, OE
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
129
BÉLAND, BOIS, SERON, DAMIEN
made only one error (he did not repeat rat /rA/,
which is an ambiguous word since the same pronunciation has different meanings: ras /rA/ ‘short’
or rat /rA/ ‘rat’). In reading aloud, he mistakenly
read one nonanimal stimulus (râteau /rAto/ ‘rake’,
that might have been confused with raton /rAtO~ / ‘a
young rat’), and failed to read one animal name (âne
/An / ‘donkey’). These results confirm the integrity
of the access to the semantic system from the OIL
and the PIL.
The Semantic System
Language testing conducted with the MT-86 b
aphasia battery revealed a severe picture-naming
deficit in both written and auditory output modalities (see Appendix A), which did not seem to interfere with the patient’s semantic comprehension.
The patient compensated for his naming deficit by
using appropriate gestures or appropriate pointing
to real objects corresponding to the pictures. For instance, when requested to name the picture of a
lamp, the patient pointed to a lamp on the
examinator’s desk. Given his severe picture naming
deficit, semantic subtests for which no speech output was required were selected to assess the integrity of the semantic system. The tests were
administered between November 1993 and April
1994.
From Caplan and Bub’s (1990) Psycholinguistic
Assessment of Language (PAL), we selected a
French adaptation of the auditory word picture
matching test comprising 60 stimuli. In this task,
the patient had to choose one of two pictures as a
match to the spoken word. Paired pictures of ani-
mals, fruit, vegetables, and object stimuli were controlled for lexical frequency, visual similarity, word
length, and semantic relationship. In the 60 word
pairs, none share phonological similarities. The patient made very few errors in this test (five errors).
His score (55/60) is, however, lower than the mean
score of five controls (see earlier) (59/60,
SD = 1.22).
OE was also subjected to the animal category
subtest taken from the Semantic Memory Battery
(Chertkow, Bub, & Caplan, 1992). In this subtest,
the patient was instructed to associate the line
drawing of an animal’s head to one of four pictures
displayed on a computer screen. Testing the animal
category consisted of asking six different probe
questions about animals, including food, legs, habitat, ferociousness, length, and height. For instance,
for the habitat probe question, the patient was requested to associate the animal’s head centred in the
screen, for example the cow’s head, to one of the
pictures displayed corresponding to four habitats:
jungle, desert, forest, and farm. In Table 5, the patient’s results are compared to the mean performance of 17 control subjects whose mean age was
70 years and whose mean education level was 12
years.
Questions related to height were the most difficult. The patient’s score for height is lower that the
lowest score obtained by the 17 controls.
Finally, the patient was administered a semantic
categorisation test (created by the speech therapists
at the Centre hospitalier Côtes-des-Neiges,
Montréal) consisting of six subtests. The patient’s
performance on all subtests, which require no linguistic output, was flawless (see Appendix D).
Table 5. Scores to Probe Questions for Patient and Controls
130
Animals
Patient
——————————
Correct
Answers %
N
Controls
——————–————————
Correct
Minimum
Answers
%
Score
SD
Food
Legs
Habitat
Ferociousness
Length
Height
10/13
12/13
11/13
10/10
9/10
5/10
196/204
207/221
214/221
163/170
151/170
147/170
77
92
85
100
90
50
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
17
17
16
17
17
17
96
94
97
96
89
86
83
78
81
84
57
53
7
8
8
6
16
17
PHONOLOGICAL SPELLING IN A DAT PATIENT
His overall performance in processing the semantic aspects of the lexicon was quite good. His
severe picture naming deficit cannot be attributed
to a semantic memory deficit and must therefore result from a deficit that affects a component located
beyond the semantic system.
could not find the word without a phonemic cue.
Tested again in January 1994, with the same stimuli
set, he obtained a score of 4/31. Eleven of the 20 errors were phonemic paraphasias (e.g. poire /pwar/
‘pear’ ® [pOj]; ananas /ananA/ ‘pineapple’ ® [anA],
2 were circumlocutions, and the remaining 7 stimuli were correctly produced after a phonemic cue
was provided. The presence of phonemic
paraphasias in naming confirms the presence of an
impairment either to the phonological output lexicon or to the phonological output buffer.
Assessment of the Output Lexicons
The Phonological Output Lexicon
The patient’s performance in both repetition and
reading aloud is excellent. However, it does not rule
out a disturbance in the phonological output lexicon because the patient may have used the
nonlexical route in word repetition and word reading aloud. OE’s use of the lexical route when reading aloud single words was assessed in a reading test
comprising regular and irregular words. Among the
54 stimuli (Croisile et al., 1995), which included 18
irregular words, the patient read 4 irregular words
incorrectly. One of these errors was a regularisation
error (i.e. nerf /ner/ ‘nerve’ ® [nerf]).
These findings indicate a mild deficit in the access to the phonological output lexicon from a visual input. Given the patient’s severe word-finding
difficulties, it was difficult to assess the functioning
output lexicon in oral picture naming. As reported
in Appendix A, his score in naming was 14/31 in
July 1993. Eight of the 17 errors produced in this
task were circumlocutions (e.g. parapluie ‘umbrella’
® protège de l’eau ‘protects from water’; nage ‘he
swims’ ® Il avance dans l’eau ‘he moves in the water’). For the remaining nine stimuli, the patient
The Orthographic Output Lexicon
A set of 54 stimuli (List 3) was administered at two
different testing times (December 1993 and March
1994), for both oral and written spelling. No significant difference in performance was found between
the first and second testings in oral spelling (c2 with
continuity correction = .83, P > .05); but OE’s performance was significantly worse at the second testing for written spelling (c2 with continuity
correction = 14.13, P < .001). The patient produced a high number of errors on regular, irregular,
and ambiguous stimuli in both tasks, as shown in
Table 6. No significant differences were found in
the distribution of errors of the three stimulus categories (regular, irregular, ambiguous) for written
and oral spelling, in either the first (c2 = 1.86,
2
P > .05) or the second testing (c = 0.06, P > .05).
The production of PPEs in both oral and written
spelling indicates that the patient could not retrieve
the orthographic representation of some of the regular words as well as irregular words. No lexical fre-
Table 6. Number of PPEs and NPPEs Produced by Patient in Oral and Written Spelling of Regular, Irregular, and Ambiguous
Stimuli
Stimulus type
(no. of stimuli)
Regular (18)
Irregular (18)
Ambiguous (18)
Total (54)
Oral Spelling
—————————————————
1st Session
2nd Session
(Dec ’93)
(Mar ’94)
PPEs
NPPEs
PPEs
NPPEs
0
9
6
11
7
6
39
2
5
3
12
10
12
44
Written Spelling
————————————————
1st Session
2nd Session
(Dec ’93)
(Mar ’94)
PPEs
NPPEs
PPEs
NPPEs
1
9
6
3
4
5
28
2
5
7
13
12
8
47
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
131
BÉLAND, BOIS, SERON, DAMIEN
quency effect was found but the total number of
stimuli was small and the frequency range might
not be wide enough to show lexical frequency effects. In the lists controlled for phonological complexity, as reported earlier, it was evident from the
patient’s results in the spelling to dictation testing
that the orthographic output lexicon and/or access
to it were severely impaired.
The patient was not, however, totally unable to
produce an accurate response in oral or written
spelling. For instance, maison, prison, lapin, cadeau,
enfant, demain, balai, and bateau were successfully
spelled on two or more occasions. Given the high
percentage of PPEs, as illustrated in Fig. 5, these
words may have been correctly spelled using a lexical analogy process and/or via the nonlexical route
with partial access to lexical knowledge (Marcel,
1980). In order to investigate this possibility, we
conducted an analysis on two types of word stimuli:
words that cannot be spelled through a
sound-to-spelling correspondence (type A), and
words which can be spelled through sound-tospelling correspondence rules (type B). The
28-word stimuli of type A included a mute E
(schwa) that has no sound correspondence at nor10
mal rate of speech , as in calepin /kalpE~/ ‘note
book’. The 10 stimuli of type B comprised a
heterosyllabic cluster without a mute E (e.g. merci
/mersi/ ‘thanks’; partie /parti/ ‘part’). Stimuli of type
A and B were matched for syllabic complexity and
lexical frequency. Results revealed that the patient
correctly spelled 15 (53%) word stimuli with a mute
E in both oral and written spelling, and never inserted an unwanted mute E in the stimuli containing a heterosyllabic cluster. Given that OE
correctly spelled a word such as calepin /kalpE~ / ‘note
book’ and never added a mute E in an inappropriate
context (e.g. merci /mersi/ ‘thanks’ as *mereci), we
conclude that access to the orthographic output lexicon is not totally impaired.
10
Summary
The input components and the semantic system are
relatively intact. The phonological output lexicon
or access to this lexicon is impaired. Access to the
orthographic output lexicon is severely impaired.
This leads us to conclude that, for the most part,
OE relied on the nonlexical route in both oral and
written spelling.
We will now turn to the assessment of the different components of the non-lexical route for spelling
in order to account for both similarities and dissimilarities identified in OE’s error pattern in the two
spelling tasks.
Common Components in the Nonlexical
Route for Spelling
The Phonological Buffer
The phonological buffer seems unimpaired because
of the patient’s good performance in word and
nonword repetition. Nevertheless, if this buffer
were only slightly damaged, errors could occur in
delayed repetition. Using a set of 244 words and 30
nonwords, we therefore requested the patient to
count aloud from 5 to 0 before he repeated each
stimulus. He produced 44 errors, which consisted
of 9 nonresponses (the patient could not remember
the stimulus), 14 perseveration errors (he repeated
the preceding stimulus), and 21 phonemic
paraphasias. There were fewer phonemic
paraphasias produced on words (12/244 = 5%) than
on nonwords (9/30 = 30%). Among these 21 phonemic paraphasias, 10 substitutions involved the
[nasal], [continuant], [voiced], and [rounded] features. The higher number of phonemic paraphasias
on nonword stimuli compared to word stimuli suggests the presence of a deficit to the phonological
output buffer.
We distinguished the word-internal mute E from the final mute E (e.g. lampe /lãp/ ‘lamp’) because the final mute E is the most
frequent spelling correspondence in French for a consonantal sound. Therefore, a patient may produce the final mute E of a word such
as “lampe” using a frequent word-final sound-to-spelling rule for a consonantal sound, i.e. without accessing the orthographic representation of the word. Word-internally, the most frequent spelling correspondence for underived and uninflected forms is a consonant
(e.g. the sound /l/ in calmant /kalmã/ ‘sedative’ is spelled with the letter l, not with the letters “le”).
132
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
The Phoneme-to-grapheme Conversion Mechanism
Analysis of the spelling errors produced via the
nonlexical route revealed two important similarities
related to the internal functioning of the phoneme-to-grapheme conversion mechanism. The
first similarity, a significant phonological complexity effect found in both spelling tasks, is related to
the segmentation subsystem. The second characteristic, the variability and frequency effects found
in the sound-to-spelling correspondences chosen
by the patient, is related to the functioning of the
phoneme-to-grapheme conversion, the other subsystem. We will examine the segmentation subsystem and its relationship with the phonological
complexity effect.
Impairment to the Segmentation Subsystem. The
first step in phoneme-to-grapheme conversion is
an explicit segmentation of the heard phonemic
string. Explicit segmentation of a phonemic string
is a metaphonological skill that develops with
reading acquisition (Morais, Cary, Alegria, &
Bertelson, 1979). Studies conducted with French
normal preliterate children revealed that segmentation into phonemes is more difficult than segmentation into syllable units. Moreover, phonemic
segmentation is more difficult with complex syllabic structures than with simple syllabic structures.
For instance, explicit segmentation of the syllable
/pi/ into phonemes (/p/- /i/) is easier than the segmentation of the syllable /pri/ ((p/-/r/- /i/) (Content, Kolinsky, Morais, & Bertelson, 1986; Lecocq,
1993). It is, therefore, reasonable to posit that OE
will experience more difficulties in phonemic segmentation of phonologically complex stimuli than
of phonologically simple stimuli. Previous work on
phonological spelling has never specifically addressed this question. Shallice (1981) suggested
that the segmentation procedure was impaired in
his patient, but he did not go into detail about the
nature of the deficit. If the explicit segmentation
procedure is impaired, the more complex the syllabic structure of the stimulus, the less likely the patient will produce a PPE. For example, for OE, the
segmentation of a phonologically complex word
(CVV$CV) such as ruisseau /rèiso/ ‘stream’ will be
more difficult than the segmentation of a phono-
logically simple word (CV$CV) such as vaisseau
/vEso / ‘vessel’. However, another possible source
for the production of NPPEs is an impairment to
the phoneme-to-grapheme conversion subsystem.
If OE were to suffer from an additional impairment
in phoneme-to-grapheme conversion, it might be
impossible to decide whether the production of the
NPPE is due to an impaired segmentation procedure, an impaired conversion procedure, or both.
At this point, two scenarios have to be considered according to the severity of the conversion deficit. First, if the conversion system is severely
altered, the deficit located at the level of the segmentation process could be masked by the deviant
phoneme-to-grapheme conversion. Imagine, for
example, that all the phoneme-to-grapheme correspondences of a stimulus were to be altered; in that
case, no phonological complexity effect would be
observable in the error pattern, since all segmented
phonemes would be incorrectly converted resulting
in a proportion of 100% of NPPEs on both simple
and complex stimuli.
Second, if the phoneme-to-grapheme conversion system were only partially altered, a larger
number of NPPEs would be expected with complex
stimuli, because, for these stimuli, two deficits—one affecting the segmentation, and one affecting the phoneme-to-grapheme conversion
deficit—would result in the production of NPPEs.
To conclude, the presence of NPPEs in the
spelling of simple stimuli indicates that the phoneme-to-grapheme conversion subsystem is altered. The presence of a significant phonological
complexity effect, that is, a higher proportion of
NPPEs on complex stimuli than on simple stimuli,
indicates that the phoneme-to-grapheme conversion subsystem is not sufficiently altered to mask
the deficit to the segmentation subsystem.
Impairment to the Phoneme-to-grapheme Conversion
Subsystem. The phoneme-to-grapheme conversion subsystem of the phoneme-to-grapheme conversion mechanism must also be impaired, because
OE produced NPPEs in simple stimuli in both oral
and written spelling. According to our hypothesis,
NPPEs produced on simple stimuli cannot result
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
133
BÉLAND, BOIS, SERON, DAMIEN
from a deficit in the segmentation subsystem because simple stimuli contain only universally unmarked CV syllables. In order to confirm this
hypothesis, the NPPEs produced on simple and
complex stimuli were analysed for their syllabic
structure. If complex stimuli were harder to segment, a lower proportion of NPPEs respecting the
syllabic structure of the target would be expected.
Conversely, if simple stimuli were less difficult to
segment, a higher proportion of NPPEs respecting
the syllabic structure of the target would be expected. Our results confirm the hypothesis in both
spelling tasks. In written spelling, only 1 out of the
53 NPPEs (1.8%) produced on simple stimuli did
not respect the syllabic structure of the target (fido
[CV$CV] ® gidor [CV$CVC]), whereas in complex stimuli, a higher percentage of the NPPEs
(60/174 = 35%) did not respect the syllabic struc2
ture of the target. This difference is significant (c
with continuity correction = 20.33, P < .001). In
oral spelling, only 4 of the 35 NPPEs
(4/35 = 11.4%) produced on simple stimuli did not
respect the syllabic structure of the target, whereas
in complex stimuli a much higher proportion
(76/157 = 48%) did not respect the syllabic struc2
ture of the target. This difference is significant (c
with continuity correction = 14.61, P < .001).
From these analyses, we conclude that nearly all
of the NPPEs produced on simple stimuli result
from an impairment to the phoneme-to-grapheme
conversion subsystem. This subsystem is, however,
only partially impaired, because as reported earlier
the patient produced a large number of PPEs in
both oral and written spelling tasks (see Appendix
C for examples). Moreover, the frequency effect
and the variability found in phoneme-to-grapheme
conversions produced by the patient argue in favour
of a relatively preserved phoneme-to-grapheme
conversion subsystem.
To summarise, the presence of PPEs on both
simple and complex stimuli argues against a totally
impaired segmentation subsystem; the presence of
NPPEs on simple stimuli argues against a totally
unimpaired phoneme-to-grapheme conversion
subsystem.
Unimpaired Graphemic Output Buffer
Patient OE did not display the typical pattern of
graphemic buffer damage proposed by Caramazza,
Miceli, Villa, and Romani (1987). The following
six characteristics of the patient’s NPPEs argue
against a functional lesion affecting the graphemic
buffer:
1. As depicted in Table 7, the spelling errors
showed no length effect for the number of letters,
phonemes, and syllables in 164 stimuli in written
spelling and 160 stimuli in oral spelling. Here
again, because of the presence of a phonological
complexity effect in OE’s spelling performance,
length effect was evaluated independently from the
phonological complexity, i.e. using only phonologically simple stimuli (CV syllabic structure).
2. There was not letter position effect. For assessment of the error rate as a function of letter position, we applied the procedure described in Hillis
and Caramazza (1995). As indicated in Table 8, the
distribution of 108 errors produced on phonologically simple stimuli did not show the typical
bow-shaped distribution (Wing & Baddeley, 1980)
resulting from damage to the graphemic buffer.
3. OE’s errors rarely violated orthographic constraints. We found only 20 examples of violations,
which are listed in Appendix C.
Table 7. Number of Spelling Errors as a Function of Stimulus Length for
Phonologically Simple Words
Syllables
1
2
2
2
2
3
134
Phonemes
Letters
Written Spelling
Oral Spelling
2
4
4
4
4
6
4
4
5
6
7
6
15/20 (75%)
21/28 (75%)
24/42 (57%)
27/47 (57%)
4/5 (80%)
16/22 (73%)
11/20 (55%)
19/28 (68%)
15/39 (38%)
19/45 (42%)
4/5 (80%)
16/23 (70%)
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
Table 8. Percentage of OE’s Spelling Errors at Each Position of the Letter String
Length in Letters
1
2
3
4
5
6
7
4 (no. of words = 49)
5 (no. of words = 43)
6 (no. of words = 70)
7 (no. of words = 5)
20
9
17
40
20
2
6
20
18
16
8
20
45
12
17
20
22
17
20
29
20
0
4. OE’s responses rarely respected the C-V information (Caramazza & Miceli, 1990). For example, the C-V spelling structure of the word cadeau
/kado/ ‘gift’ is CVCVVV. A spelling error that respects the C-V structure would have to present the
same C-V sequence. For instance, an error such as
cadeau /kado/ ‘gift’ ® “cadau” does not respect the
C-V structure, whereas an error like cadeau /kado/
‘gift’ ® “cadeou” CVCVVV does. Only 20% of the
errors in written spelling and 14% of the errors in
oral spelling respected the C-V structure of the
stimulus.
5. There was a dissociation in the error pattern
between delayed copying and spelling.
6. Spelling errors were influenced by phonological factors, given that the proportion of NPPEs
varies with the phonological complexity of the
stimuli.
Assessment of Components That Are
Specific to Written Spelling and Oral
Spelling
Components that Are Specific to Oral Spelling
The Letter Name Conversion Mechanism. This is a
peripheral component that translates an abstract
letter representation into a letter name. Except for
11
Q, letters have one letter name , generally mastered in first grade with the alphabet acquisition.
The letter name conversion mechanism performs a
letter-by-letter segmentation of the orthographic
representation and associates a letter name to each
segment. Twenty-four of the 26 letter names are
monosyllabic forms involving either an open syllable (e.g. B = /be/, P = /pe/) or a closed syllable (e.g.
F = /ef/, L = /el/, N = en/). The letter names of Y
and W comprise two monosyllabic words: Y = i grec
11
/i grek/ ‘Greek i”; W = double v /dublœ ve/ ‘double
V’.
To test OE’s knowledge of letter names, we
asked him to read aloud letter sequences ranging in
length from two to five letters (e.g. iv, svag) for a total of 111 letters. This test was administered in
March 1994, when we observed poor performance
in writing isolated letters that were dictated to him
(see below). OE made 11 errors out of a total of 111
letter stimuli (10%). In four sequences, the patient
read the letter q /kY/ as [kA], the letter name corresponding to the letter K. Three errors involved
voicing (e.g. v read as [Ef], two involved the nasal
feature (v and f read as [Em]). In one case, h is read
as /i/ and finally, the letter “p” is read as [En]. These
results indicate a partially disrupted letter name
conversion mechanism, at least from the standpoint
of a visual input. Five of the 11 errors, i.e. those involving the substitution of features [± nasal] and
[± voiced], were akin to the errors found in OE’s
written and oral spelling of word stimuli.
The Phonetic Output Component. Voicing errors
were numerous in written spelling. However, they
rarely occurred in oral spelling and reading aloud,
and were not found in repetition or in copying. If
voicing errors are obvious in written spelling and
copying (e.g. the sound /p/ written as “b”), these
same voicing errors are more difficult to perceive in
tasks involving speech output such as repetition,
reading aloud, and oral spelling. If OE suffers from
a subtle disorder affecting the production of the
voice onset time (VOT) in stop consonants, written
transcriptions of tape-recorded responses may not
then be efficient. In order to rule out the possibility
of a phonetic disorder in the production of the voicing feature for stop consonants, we submitted the
Q is named either as /kû/ or /kY/.
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
135
BÉLAND, BOIS, SERON, DAMIEN
patient to a VOT production test (Ryalls &
Larouche, 1992) at two different times in the evolution of the degenerative disease, with a 6-month
period between each testing. In this test, the patient
was requested to read aloud monosyllabic CV or
CVC word stimuli comprising the six French stop
consonants (/p,b,t,d,k,g/). Each consonant was
combined with each of the three vowels /i/, /a/, /u/
for a total of 18 word stimuli that were repeated 5
times each (a total of 90 monosyllabic word stimuli). The patient’s production was first recorded on
a digital audiotape recorder, then transferred to a
hard disk and finally analysed by means of
Macintosh Sound Tools II program (Sound Designer II Software by Brooks et al., 1992) and
Digidesign Pro Tools Audio Interface. For each
testing session, we calculated the mean VOT difference between the voiced and unvoiced stop consonants (VOT of voiced stop consonant – VOT of
12
unvoiced stop consonant ). Results indicated that
the patient’s mean VOT difference at both testing
times fell within 1 SD of the mean VOT difference
of 10 controls, matched for age and education. The
patient’s mean VOT difference was –198msec at
Time 1 and –164.7msec at Time 2, whereas the
controls’ mean VOT difference was –155.1msec,
SD 42.6msec.
These findings rule out the possibility of a slight
impairment to the phonetic output system that
would affect the production of the voicing feature,
at least in the case of the stop consonants, in any
task requiring speech output. This analysis allows
us to eliminate the possibility that the patient was
also committing voicing feature errors in oral spelling that went undetected by the tester. The importance of this phonetic analysis will be underscored
in the Discussion session.
Components That Are Specific to Written Spelling
The Allographic Conversion Mechanism. As illustrated in Fig. 5, both oral and written spelling of
words and nonwords share the same components
from the phonological buffer to the graphemic
buffer. Beyond this shared route, separate conver12
sion mechanisms are involved. An impairment affecting only the allographic conversion mechanism
will result in a dissociation between oral and written
spelling. It is therefore important to examine the
functioning of this mechanism in tasks such as
copying and written spelling.
Performance in Copying. The stimuli set administered in copying was made up of 71 phonologically
complex words, 65 phonologically simple words, 30
nonwords (a subset drawn from experimental lists),
and 40 letter sequences of 2 to 5 letters (e.g. pkh, db,
svldf). A low percentage of errors was found in
copying 18/206 = 8.7%). Among those errors, we
counted 5 letter omissions; 11 letter substitutions (j
® “g”, g ® “q”, o ® “a”, z ® “s”, b ® “d”, f ® “b”),
and 2 omissions of a cedilla and a circumflex.
In order to investigate if OE was copying slavishly, we tested OE’s ability in copy transcoding.
He produced 6 errors on 109 stimuli in converting
print to cursive lowercase (ç ® , z ® ,â ® , o
® , a ® , au ®
), 4 errors on 35 stimuli
in converting cursive lowercase to uppercase ( ®
G, ® Q , ® Q , ® Æ), and finally only 1 accent error on 20 stimuli (CHATEAU ‘castel’ ®
“chateau” instead of the correct form château) in
converting uppercase to cursive lowercase.
Samples of the patient’s output in copying from
upper-case letters to cursive handwriting and vice
versa are given in Fig. 6.
The patient’s ability in delayed copying was also
assessed. In this task, the written stimulus was
shown for 1 second and then withdrawn. The patient was requested to count aloud from 5to 0 before
he copied the stimulus. He wrote 15/165 stimuli incorrectly (9%). The stimuli set contained 74 phonologically complex words, 61 phonologically
simple words, and 30 nonwords. As in immediate
copying, four of the involved letter pairs (g/q; b/p;
a/o; z/s) have a similar sound correspondence. The
remaining nine errors were letter omissions
(N = 2), letter additions (N = 1), and phonologically plausible errors (N = 5) (e.g. glaner /glane/ ‘to
glean’ ® “glané” ‘gleaned’). Note that the strong
In French, the VOT value is positive for the unvoiced stop consonant and negative for the voiced stop consonant.
136
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
Summary
Fig. 6. A sample of OE’s copying from upper-case letters to cursive
handwriting and vice versa.
dissociation between the low percentage of errors in
delayed copying (9%) and the high percentage of
errors in the two spelling tasks (50%) represents an
additional argument against the hypothesis of a
deficit affecting the graphemic buffer.
Performance in Writing Dictated Single Letter
Names. OE was assessed three times for dictated
lowercase letters, once in October 1993 and twice in
March 1994. He obtained a close to perfect score
the first time (two errors: r ® “q” and j ® “g”). On
March 16th he committed 6 errors, and 10 on
13
March 23rd . The errors made in March 1994 do
not speak in favour of a disrupted allographic conversion mechanism, as most of these errors did not
involve letters with a similar visual shape.
The Grapho-motor Process. As illustrated in Fig.
6, the patient’s handwriting is normal; letters are
legible and well-formed in both types of writing.
A detailed analysis of the patient’s hand movements while writing to dictation will be presented
later.
The following functional lesions have been localised: access to the orthographic output lexicon is severely impaired; access to the phonological output
lexicon is impaired. Both subsystems of the phoneme-to-grapheme conversion mechanism are impaired because of the presence of NPPEs on both
phonologically simple and complex stimuli. The
allographic conversion and the letter name conversion are both mildly impaired in the early testing.
Impairment to both the orthographic output
lexicon and the phoneme-to-grapheme conversion
mechanism account for the similarities in the error
pattern found in written and oral spelling. However, we have not yet identified the origin of the single feature errors that are much more abundant in
written than in oral spelling. In the following section, we question the possibility that these single
feature errors might in fact result from confusion in
the visual shape of the letters or in the motoric
movements involved in the grapho-motor process
rather than from a confusion at the phonological
level.
Dissociation affecting the Single Feature
Errors
Hypothesis of a Confusion in the Visual Shape of the
Letters
According to Goodman and Caramazza (1986),
the abstract graphemic representations processed in
the allographic conversion system are specified for
type (print or cursive), case (upper or lower), and
visual shape. Given the patient’s performance in
copying, we have already eliminated the possibility
of a deficit affecting the processing of letter type
and letter case; however, there still remains the possibility that the patient confuses letters that have a
similar visual shape. For instance, the higher percentage of voicing errors found in written spelling
could be attributed to the visual similarity of voiced
and unvoiced stop consonants (e.g. p and b) rather
than their phonological similarity (e.g. /p/ and /b/).
13
Errors produced on March 16th: b® p; r® l; j® q; x® v; c® s; k® q. On March 23rd: q® c; y® z; g® b; h® g; x® h; w® (no response); k® q; i® e; j® g; r® h.
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
137
BÉLAND, BOIS, SERON, DAMIEN
Goodman and Caramazza were not specific about
what exactly is meant by visual shapes for abstract
forms. They interpreted a substitution of /t/ for /r/
(chair ® chait) as the result of a confusion in the visual letter shape process, but provided us with no
explanation as to which letter pairs were more likely
to be confused.
In order to test the hypothesis of confusion arising from a visual similarity between letter shapes,
we needed first to settle on visual confusion matrices. In written spelling the patient was requested to
write in lowercase. In oral spelling, the patient may
rely on abstract representations, lower-case or upper-case letter representations. The hypothesis of
visual similarities was therefore tested for both
lower-case and upper-case letters. Two different
confusion matrices were selected: the confusion
matrix proposed by Meulenbroek and Van Galen
(1990) for the lower-case letters and the one proposed by Gibson (1969) for the upper-case letters.
For both analyses (lowercase and uppercase), we
focused our attention on the 16 letter pairs listed
below, which could be construed as phonological
confusions involving one of the four phonological
features found in the dissociation between written
and oral spelling.
[± voiced] = pb,td,fv,kg,cg,qg,sz
[± continuant] = bv,pv,fb,fp
[± rounded] = ao
[± nasal] = vm,mp,mb,fm
Visual Shape Similarities in Lower-case Print. According to Meulenbroek and Van Galen (1990),
the letter pairs that are more likely to be confused
are those that are spatially ambiguous. Among the
16 letter pairs listed above, only p and b are qualified
as such. We added two other letter pairs, sz and qg,
which we consider to share common visual features.
14
The sound correspondences of these three letter
pairs (pb, sz, and qg) present the [±voiced] contrast.
In combing through all 103 voicing errors, we
counted 37 in which p and b were confused, 15 in
14
which q and g were confused, and 2 in which s and
z were confused. If we subtract these 54 ambiguous
errors, due to the fact that they can arise from confusion of either their similar phonological forms or
their visual similarity, there still remain 49 voicing
errors (e.g. vanité /vanite/ ‘vanity’ ® “fanidé”) that
cannot be said to reflect a visual similarity (e.g. ch
® “j”; f ® “v” and t ® “d”) and can only result from
confusion at the phonological representational
level.
In summary, for three of the four features, there
is no similarity in the visual shape of the letter pairs.
For the voicing feature, after subtracting the visually similar pairs and again comparing voicing errors in written and oral spelling, we are still left with
more voicing errors in written (N = 49) than in oral
spelling (N = 11).
Visual Shape Similarities in Upper-case Print. Similarities between visual shapes of letters in upper-case print were established on the basis of
Gibson’s study (1969). As illustrated in Table 9, we
drew the same 16 letter pairs listed earlier from the
author’s chart of distinctive features for a set of
graphemes. For each letter pair, e.g. P ® “B” (and B
® “P”), we determined the number of features
shared between the intended letter (e.g. P) and the
substituting letter (e.g. B). We also determined
which letters shared the same number of features as
the intended letter, and finally, which letters shared
a larger number of features with the intended letter.
Table 9 shows that the patient substituted letters
that did not share any features (e.g. F and V share
no feature). Other letter pairs shared up to three
identical features (e.g. P and B; B and P). However,
In the case of q and g, it is not possible to know if the input of the allographic conversion mechanism for the sound /k/ is the abstract graphemic representation for the letter c, the letter k, or the letters qu or ch, since the patient relied on the phoneme-to-grapheme
conversion mechanism for spelling. We therefore considered all voicing errors involving the sound /k/ and /g /, regardless of their
spelling in the stimulus. For instance, we counted as a possible visual error the stimulus koala /koala/ ‘koala’, written as goala, even if
the letters k and g are not visually similar, because we do not know if the patient was mapping a print representation like “quoala”. In the
same way, corail /koraj/ ‘coral’, written as “garail”, is also considered as a possible error resulting from a confusion between visual letter
shapes of q and g because the patient might have been mapping a representation like “quorail”.
138
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
P
B
D
T
V
F
G
C
G
K
G
Q
Z
S
B
V
P
V
M
V
P
M
B
M
B
F
P
F
M
F
O
A
B
P
T
D
F
V
C
G
K
G
Q
G
S
Z
V
B
V
P
V
M
M
P
M
B
F
B
F
P
F
M
A
O
Intended Letter
of Input Stimulus
Substituting
Letter in
Output Stimulus
0
0
0
0
0
1
1
0
0
3
3
2
2
3
3
2
2
3
3
2
2
1
1
3
3
2
2
0
0
1
1
0
No. of Shared
Features Between
Input and
Output Letter
I, M, N, V, W, X, Y, B, D, O, P, R, Q, U
I, L, Z, C, J, S, U
I, M, N, V, W, X, Y, B, D, G, O, P, R, U
A, F, H, I, L, T, K, N, V, X, Y, B, D, O, P, R, Q, U
I, N, B, C, D, J, O, P, R, Q, S, U
E, H, I, T, N, C, Z, D, G, O, R, Q, U
L, N, C, U
F, L, G, J, S
W, Z, C, G, J, S, U
A, W, X, Y, K
E, H, I, T, N, X, B, R
F, D
A, E, I, N, Y, D, Q
E, H, I, T, N, V, X, R
H, T, K, D, P, R
I, M, N, Y, Z
A, I, W, X, Y, O, Q
A, L, K, R
H, T, K, B
I, N, Y, Z, B
D, P
L, C, D, G, U
E, H, I, T, K, M, V, W, X, Y, C, P, R, Q, U
H, T, K, M, D, R,
H, T, K, F,
N, X, Z
E, H, I, K, M, Y, O, P, R
W, C, J, O, S, U
L, G, J, P, S
A, E, H, I, T, K, M, V, W, X, Y, B, D, J, O, S, U
A, E, F, H, L, T, Z, J, S
J, S
Other Letters that Share the Same
No. of Features
Table 9. Visual Structural Similarity between Intended Letter and Its Substitute
E
R
R, P, I, L, M, Y, B, A, K, E, F, H
B
X, D, G, Q, Y, Z, B, I, M, N, P, R, A, L, K, E, H, T
E, H, I, T, N, Z, B, C, D, O, R, Q, U, A, K, M, W, X, Y
—
—
A, E, F, H, I, L, T, M, N, V, W, X, Y, Z, B, C, D, O,
P, R, Q, U
A, E, F, H, L, T, Z, C, J, S
A, E, F, H, T, K, M, N, V, W, X, Y, B, D, O, P, R
A, E, F, H, L, T, Z, C, J, S
E, M, W, C, G, J
G, H, K, M, V, W, X, Y, A, E, F, L, T
A, K, M, W, X, Y
A, F, I, O, Q, H, T, K, M, D, P, R, E
E, H, I, T, N, Z, B, C, D, O, R, Q, U, A, K, M, W, X, Y
L, X, O, A, E, I, M, N, Y, D, Q, F, H, T, K, B, R
—
A, W, K, Y
E, H, I, T, N, V, X, B, R, A, W, K, Y
F, H, T, K, B, R
A, W, K, Y
E
A, L, K, P, R, E, H, T
H, T, K, M, D, P, R, E
E, H, T
R
A, L, K, P, R, E, H, T
E, H, I, T, N, V, X, B, R, A, W, K, Y
I, N, Z, B, P, Q, E, F, V, W, R, H, T, M, X, Y, K
B, D
Letters that Share a Larger No. of
Features with Input Letter
PHONOLOGICAL SPELLING IN A DAT PATIENT
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
139
BÉLAND, BOIS, SERON, DAMIEN
as indicated in Table 9, for the letter B there are
many letters other than P (e.g. H, T, K, F) that
share the same number of features (three) with B, or
even more features with B (e.g. R shares four features with B), yet the patient did not confuse them.
Thus, for upper-case letters, it is unlikely that
the substitution errors affecting one of the four
phonological features mentioned earlier resulted
from confusion involving the visual letter shape
process. It is not possible to conclude for any of the
16 pairs listed earlier that confusion may result from
a similarity in visual letter shape.
In summary, the dissociation between written
and oral spelling does not completely vanish under
the hypothesis of damage to the visual shape process in the allographic conversion mechanism.
Only 54 of the 103 voicing errors found in written
spelling could possibly be interpreted as the result
of confusion between any of the lower-case letters
with similar visual shapes.
Hypothesis of a Confusion in the Grapho-motoric
Patterns
As we reported earlier, letters in written spelling
and copying were well formed. The patient had no
problems in executing the sequence of movements
that create letters. However, it is still possible that
OE suffered from a slight deficit in the transfer
from the allographic conversion system to the
graphic motor processes that would be responsible
for confusion between letters involving similar
grapho-motor gestures. According to this hypothesis, some substitutions might in fact result from
confusion between letters that share many
grapho-motor patterns rather than from a phonological confusion.
First, we will examine what proportion of single
feature errors could result from a confusion in the
grapho-motor patterns. Second, we will analyse the
performance of the patient in two tasks in which the
grapho-motor output is not involved: block letter
spelling and computer keyboard spelling.
Analysis of the Patient’s Grapho-motor Gestures. The first step was to analyse OE’s handwriting in order to identify the letter pairs that displayed common strokes. Different testing sessions
140
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
with the patient were videotaped on equipment
that allowed us to perform a frame-by-frame analysis of the patient’s hand movements while writing
to dictation. Following the methodology proposed
by Meulenbroek and Van Galen (1990), we deconstructed the patient’s cursive letters into strokes
on the basis of changes in direction. We were, thus,
able to capture the segmentation of 22 letters of the
alphabet as illustrated in Fig. 7 (letters K, W, Y, and
Z were not produced by the patient on videotapes).
The analysis of this segmentation indicates that
the letter pairs sharing two or more motoric movements were: qg , cg , cq, cd, ao, co, dq, dg , vm, tl, bt,
bl, rm, rv, ui, mn, and jp. Among these 17 pairs,
only the 4 letter pairs qg , cg , ao, and vm corresponded to letter substitutions that may also be interpreted as single feature errors. The letters in the
pairs qg , cg , share similar motoric movements but
they are also phonologically similar since they share
all features but the [± voiced] one. Letters in the ao
pair share similar motoric movements and all phonological features but the [± rounded] feature.
Finally, letters in the vm pair share motoric movements and all features except the [± nasal] feature.
We will hypothesise that errors involving these four
letter pairs arise from an impairment to the
grapho-motor processes rather than from a phonological confusion due to similar phonological representations. We will examine the pairs in turn,
regrouping them with respect to the contrastive
phonological features: [± voiced], [± rounded], and
[± nasal].
1. [± voiced]: qg , cg . From the 103 total voicing errors collected in written spelling, only 13 corresponded to substitutions between the letters qg
and 2 to substitutions between the letters gc.
Therefore, if these errors were to result from a confusion in their motoric movements, this would account for 14.5% (15/103) of the total voicing errors.
2. [± rounded]: ao. All of the 35 roundness
errors collected in written spelling involved a/o substitutions. All of the [± rounded] errors in written
spelling may thus result from impaired graphomotor processing.
3. [± nasal]: vm. The letters v/m have three
strokes in common. Among the 37 errors involving
PHONOLOGICAL SPELLING IN A DAT PATIENT
Fig. 7. Segmentation of OE’s letters. Unless specified with arrows, all first strokes of letters begin at the bottom left and move towards the
upper right.
the features [± nasal] in written spelling, only 2 errors affected the letter pair v/m: vélo /velo/ ‘bike’ ®
“mélo”; vaquer /vake/ ‘to attend to’ ® “maquin”.
The remaining 35 errors involved letter pairs that
did not share similar strokes (e.g. boni /bOni/ ‘profit’
® “moni”; fureter /fYrte/ ‘to pry about’ ® “murdé”).
In summary, results indicate that the dissociation between written and oral spelling remains almost unchanged for the voicing and the nasal
errors. This dissociation may, however, disappear
for the [± rounded] feature.
Block Letter and Computer Keyboard Spelling. If
spelling errors result from an impairment to the
grapho-motor process, these errors should disappear when OE is tested in block letter spelling or in
computer keyboard spelling. Testing with block
letters reveals that the error pattern is identical to
the one found in written spelling. The patient pro-
duced 19 errors out of 20 stimuli that were akin to
errors found in written spelling, that is, he produced
single feature errors such as choosing the letter P for
the sound B.
OE was not cooperative in the computer keyboard spelling task, which precluded extensive testing. In February 1994, we videotaped a testing
session in which OE was requested to type 26 complex word stimuli. He produced 2 correct responses,
1 PPE, and 23 NPPEs which consisted of 6
[± voiced] errors; 4 a/o errors; 1 [± continuant] error; 1 [± nasal] error; and 11 elision errors. Note
that all single feature errors, except the f/v and the
b/m substitutions, involve keys that are distant on
the keyboard. The presence of a/o errors allows us
to rule out the possibility that these errors, also
found in written spelling, were due to a deficit in the
grapho-motor process. Although the number of
stimuli is quite small, this test indicates that the oriCOGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
141
BÉLAND, BOIS, SERON, DAMIEN
gin of the typing errors is situated at a component
located upstream of the grapho-motor process.
Summary. We first considered damage to the
allographic conversion mechanism. The patient’s
performance in immediate and delayed copying was
not flawless, but he produced no letter type substitutions (e.g. a ® ) or letter case substitutions (e.g.
A ® ) errors. We then examined the possibility of
an impaired visual shape process that would cause
confusion between letters with similar visual
shapes. We tested this hypothesis for visual similarities between lower-case letters as well as upper-case letters, since it was not possible to specify
in what letter case the patient’s graphemic representation occurred.
For the lower-case letters, 54 of the 103 errors
affecting the voicing feature could have resulted
form damage to the visual shape system within the
allographic conversion mechanism because these
errors involved phoneme pairs that corresponded to
graphemic representations whose visual shapes
were similar (pb; qg; sz). Once these ambiguous errors were removed, there was still a dissociation between written and oral spelling for voicing errors.
Analysis for visual similarities in upper-case letters
revealed that no substitutions among the 16 letter
pairs listed could have resulted from confusion of
the visual letter shape. Given these findings, we rejected the hypothesis of a selective deficit to the
allographic conversion mechanism accounting for
the qualitative dissociation between written and
oral spelling.
We looked into possible damage affecting the
transfer from the allographic conversion system to
the grapho-motor processes. We segmented the
patient’s cursive handwriting to identify which letter pairs shared common strokes. Some of them
also shared common phonological features such as
[voiced] (e.g. q/g), [rounded] (e.g. a/o) and [nasal]
(e.g. v/m). Once we had removed these written
spelling errors that may have resulted from a deficit
in the transfer from the allographic conversion to
the grapho-motor processes we still faced a dissociation between written and oral spelling. There were
more errors affecting the voicing and the nasal features in written spelling than there were in oral
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
spelling. We therefore rejected the hypothesis that
a selective deficit affecting the transfer from the
allographic conversion system to the grapho-motor
processes accounted for the dissociation between
written and oral spelling for single feature errors.
Multiple Deficit Hypothesis.
As a last attempt, we will now consider the hypothesis of multiple deficits (one in the allographic conversion and one in the transfer from the allographic
conversion to the grapho-motor process) to see if
this could account for the dissociation. As reported,
a deficit in the allographic conversion would account for 54 of the 103 voicing errors, whereas all
other single feature errors would remain unexplained. A deficit affecting the transfer from the
allographic conversion to the grapho-motor process would account for 15 [± voiced] errors, 35
[± rounded] errors, and 2 [± nasal errors in written
spelling. The 15 voicing errors are the same as those
that could have been accounted for by a deficit in
the allographic conversion, and therefore do not
help to reduce the dissociation for voicing errors.
When we reanalyse the dissociation between written and oral spelling for single feature errors by removing all the single feature errors that may have
resulted from a deficit either in the allographic conversion or in the transfer from the allographic conversion to the grapho-motor process, we obtain the
distribution of errors given in Table 10.
Dissociation for the features [± voiced],
[± continuant], and [± nasal] still holds. A number
of single feature errors (more in written than in oral
spelling) cannot be accounted for by a deficit affecting either the allographic conversion or the transfer
from the allographic conversion to the
Table 10. Distribution of Single Feature Errors in Written and
Oral Spelling According to the Multiple Deficit Hypothesis
Feature
[± voiced]
[± continuant]
[± rounded]
[± nasal]
No of Errors
—————————————–
Written Spelling
Oral Spelling
49
12
0
35
11
0
18
24
PHONOLOGICAL SPELLING IN A DAT PATIENT
grapho-motor process. Dissociation for the
[± rounded] feature is now reversed. More errors
are produced in oral than in written spelling. Thus,
the hypothesis of multiple deficits affecting components that are specific to written spelling does not
readily account for the dissociation, which persists
for three of the four features. We will now examine
the possibility that the dissociation results from a
deficit affecting the transfer between two components that are specific to written spelling.
Hypothesis of a Deficit in the Transfer between Two
Subcomponents Specific to Written Spelling
In the previous sections, we attempted to localise
the component that was responsible for the production of single feature errors. We hypothesised that
it was specific to written spelling, since these errors
were much more frequent in written spelling than
in oral spelling. We failed to identify such a component. We are therefore left with two possibilities.
The first is that there are two phoneme-to-grapheme conversion mechanisms: one
for written spelling and one for oral spelling. Single
feature errors would then occur because of a failure
in the phoneme-to-grapheme conversion mechanism for written spelling. This possibility cannot be
totally ruled out but it would be redundant and
would entail important modifications in the functional architecture. The second possibility, which is
the one we are adopting, is that OE suffers from a
deficit affecting the transfer between two components. The different deficits in OE are indicated by
X symbols in Fig. 8.
In both written and oral spelling, OE relies on
both the lexical and the nonlexical route. As reported earlier, OE correctly spelled a number of irregular stimuli that cannot be spelled without
access to the orthographic output lexicon. In both
written and oral spelling, OE must also use the
nonlexical route for spelling, because of the produc-
Fig. 8. A modified version of the functional architecture model for writing showing the two subsystems of the PGC mechanism. The
functional deficits in OE are indicated by Xs.
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
143
BÉLAND, BOIS, SERON, DAMIEN
tion of an important number of PPEs. We reported
a significant phonological complexity effect: That
is, OE produced more PPEs on phonologically
simple stimuli than on phonologically complex
stimuli. Shallice (1981) has suggested that the
nonlexical route for writing involves at least two
stages: (1) the segmentation of the string of phonemes (or possibly groups of phonemes); and (2)
transformation of these units into a graphemic
form. These two stages are illustrated in Fig. 8 as
two subcomponents of the phoneme-to-grapheme
conversion mechanism. OE’s performance indicates that the segmentation procedure, at least in
French, might involve syllables in addition to phoneme units. The segmentation appears to be more
difficult for OE in complex than in simple syllable
structures, a result that is more difficult to explain if
segmentation were based on phoneme units only.
The segmentation into syllable units is also confirmed by the production of syllabic repairs found in
both oral and written spelling. An impairment in
this segmentation procedure accounts for the phonological complexity effect that is found both in
oral and written spelling. As illustrated in Fig. 8,
the output of the segmentation procedure feeds the
phoneme-to-grapheme subcomponent. A frequency effect in the selection of the phoneme-to-grapheme correspondence was found in
both written and oral spelling, indicating that OE
uses this subcomponent in both tasks.
In written spelling, the output of the phoneme-to-grapheme conversion mechanism is sent
to the graphemic buffer then to the allographic conversion, and finally, to grapho-motor process. As
indicated in Fig. 8, the transfer from the graphemic
buffer to the allographic conversion mechanism is
impaired. The deficit slows down the writing process and increases the need to reconvert the stimulus in order to refresh the trace in the graphemic
buffer. Because OE experiences difficulties in independently generating lexical phonological information (cf. his moderate difficulties in word-finding
and picture naming), he must rely entirely on the
trace in the phonological buffer, a trace that decays
rapidly. According to this proposal, single feature
errors occur while OE reconverts the phonological
representation held in the phonological buffer.
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
This reconversion, relying on a decayed phonological representation, results in single feature errors. In
oral spelling, no reconversion is required since the
transfer from graphemic buffer to the letter name
conversion mechanism is unimpaired, resulting in
less frequent single feature errors.
According to this interpretation, the dissociation affecting single feature errors should also be
found in written picture naming. Although responses in picture naming were very hard to obtain
because OE was suffering from severe
word-finding difficulties, the few responses that
were collected showed the same error pattern: i.e.
more single feature errors in written picture naming
than in oral spelling. For instance, when requested
to produce the word enfer /ãfer/ ‘hell’, OE correctly
spelled E-N-F-E-R orally, but wrote it as “enver”.
In the written picture naming of the MT-86 b, he
produced the following errors: lampe /lãp/ ‘lamp’ ®
“lambe”; parapluie /paraplèi/ ‘umbrella’ ®
“barabluie”; village /vilaZ/ ‘village’ ® “fillage”. The
size of the data set collected in picture naming is,
however, too small to ascertain a significant dissociation in the single feature error pattern in written
vs. oral spelling in picture naming.
Another prediction is that single feature errors
should be found not only in written spelling, but
also in any task requiring the contribution of the
working phonological memory system, that is, any
task requiring the refreshment of a phonological
trace in the phonological output buffer. A close examination of OE’s performance in different tasks
involving the phonological working memory reveals that he also produced single feature errors in
those tasks. The tasks are the following: delayed
nonword repetition, rhyme judgement in auditory
modality, and auditory nonword–written nonword
matching test. We will now examine OE’s performance in each of these tasks in turn.
Delayed Nonword Repetition
As reported earlier, to assess the integrity of the
phonological buffer, OE was administered a delayed nonword repetition task with articulatory
suppression. Since nonwords do not have a
permanent phonological representation, delayed
nonword repetition necessarily involves the work-
PHONOLOGICAL SPELLING IN A DAT PATIENT
ing phonological memory system. With
articulatory suppression, OE produced 9 errors on
the 30 nonword stimuli, 5 of which corresponded to
single feature errors (e.g. tapo /tapo/ ® [dapo]).
Rhyme Judgement in Auditory Modality
Out of 99 stimuli, OE produced 8 errors in rhyme
judgement in auditory modality, 7 of which involved single feature errors (e.g. OE’s response was
yes in the rhyme judgement of the word pair hiver
/iver/ ‘winter’–enfer /ãfer/ ‘hell’).
Auditory Nonword–Written Nonword Matching
Task
In auditory nonword matching tasks, OE produced
a total of 2 errors in December 1993 and 7 errors in
April 1994, out of 30 stimuli (e.g. OE’s response to
the auditory target /baZo/ was the written nonword
bacho /baSo/). The mean number of errors in this
task for 5 controls was 0.2 errors for 30 stimuli. The
increment in the number of OE’s errors within a
4-month period indicates that the impairment to
the phonological working memory is progressive.
The production of single feature errors in this task
was congruent with our proposal of an impairment
to the phonological working memory system, since
in this task, the patient has to hold the phonological
form temporarily and segment this form before
pointing to the target.
In summary, single feature errors are not exclusively found in written spelling. OE’s performance
in other tasks that tax the phonological working
memory system is characterised by an in ability to
handle single featural differences in the phonological form of the stimuli. Single feature errors did not
occur in reading aloud, immediate repetition, and
copying, because these tasks do not require an explicit segmentation of the sound word form and because they don’t tax the phonological buffer.
According to this interpretation, the total number
of spelling errors in both spelling tasks should be
comparable, because the error rate results from a severe deficit affecting the orthographic output lexicon, a component shared by the two spelling tasks.
However, because a number of NPPEs produced in
written spelling correspond to single feature errors,
a higher number of PPEs is expected in oral than in
written spelling, which is not the case (PPEs: in oral
spelling = 97/440 [22%]; in written spell2
ing = 89/440 [20%], c with continuity correction = .33, P > .05).
A close examination of the distribution of
NPPEs reveals that three error subtypes were more
frequent in oral than in written spelling: (1) accent
errors were more frequent in oral (25 accent errors)
than in written (3 accent errors) spelling; (2) all the
9 letter name errors were found in oral spelling; and
(3) unattested sound-to-spelling correspondences
were more frequent in oral (N = 41) than in written
spelling (N = 22). Among these three error subtypes, accent and letter name errors result from
malfunctioning of components that are specific to
oral spelling and are therefore not likely to be found
in written spelling. As already mentioned, accent
errors may result from a natural tendency to avoid
accents when orally spelling in French. Letter name
errors occurred when OE resorted to a more direct
route for oral spelling by converting phonemes directly into letter names rather than converting phonemes into graphemes, then into letter names.
These two errors types would have been categorised
as PPEs rather than NPPEs under less stringent
criteria (see, for instance, Hafield & Patterson,
1983). When accent and letter name errors, which
both contribute to increase the number of NPPEs
produced in oral spelling, are removed from the total errors in both spelling tasks, the following distribution of PPEs and NPPEs is obtained: 89 PPEs
vs. 224 NPPEs in written spelling, and 97 PPEs vs.
124 NPPEs in oral spelling, that is, as expected, a
significantly higher proportion of PPEs in oral than
2
in written spelling (c with continuity correction = 12.96, P < .001). In other words, letter name
and accent errors in oral spelling led to an equalisation of the proportion of PPEs produced in both
spelling tasks.
GENERAL DISCUSSION
Analyses of OE’s spelling errors reveal that only a
low percentage of the errors, categorised as “miscellaneous”, failed to be phonologically principled.
The remaining errors, PPEs, tortuous spelling erCOGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
145
BÉLAND, BOIS, SERON, DAMIEN
rors, accent errors, phonological single feature substitution errors, and phonological repairs were all
phonologically principled. In both oral and written
spelling, the proportion of PPEs and NPPEs varied
with the phonological complexity of the stimuli.
The error pattern (which was very similar in both
tasks) indicates that the patient was using the
nonlexical route for spelling. There was, however, a
qualitative dissociation for the substitution error
pattern found between oral and written spelling.
Substitution errors affecting one of the four phonological features [± voiced], [± continuant],
[± rounded], and [± nasal] were more frequent in
written spelling than in oral spelling, and the dissociation applied to both words and nonwords.
The production of phonological errors affecting
four phonological features may not be specific to
our patient, but the percentage of these errors is certainly higher than in the other cases of phonological
spelling described in the literature. For instance, in
the corpus of errors reported by Beauvois and
Dérouesné (1981), only 13 errors involve these 4
phonological features (7 errors affecting the voicing
feature, 2 errors affecting the continuant feature, 3
errors affecting the round feature, and 1 affecting
the nasal feature). Hatfield and Patterson (1983)
reported a few voicing errors (e.g. borough ®
“purough”; shampoo ® “shambow”), but these errors were also present in oral reading.
Our objective in this study was to find a way to
account for the observed dissociation for single feature errors, which were much more frequent in
written than in oral spelling. Our analyses revealed
that none of the interpretations proposed in the literature would account for OE’s performance.
Goodman and Caramazza (1986) and Lesser
(1990) reported a dissociation in their patient’s performance between oral and written spelling. The
dissociation found in MW (Goodman &
Caramazza, 1986) was attributed to damage to the
allographic conversion system. As we have shown,
this interpretation was ruled out in our case because
damage to this component would account for only a
subset of the single feature errors.
In Lesser’s case, the dissociation was attributed
to the reliance on a more direct route in oral spelling, which bypasses the orthographic lexicon and,
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
hence, results in a greater production of PPEs in
oral spelling than in written spelling, and in greater
lexicality effects in written spelling. We investigated the possibility that the dissociation in OE resulted from selective damage to the writing buffer.
However, as reported earlier, our patient used the
nonlexical route in both written and oral spelling,
and his errors in written spelling were not characteristic of a buffer impairment.
Our solution resembles Berndt and Mitchum’s
case (1994). Their patient, LR, produced voicing
errors when reading aloud, but only when she had
to read a syllable. The authors reported that LR’s
oral reading of isolated letters was flawless. LR correctly produced the sound [pi] for the letter P, but
incorrectly produced [bo] for the letter sequence
“PO”. Voicing errors only occurred when the phonetic realisation involved the blending of two
sounds. According to Berndt and Mitchum, LR’s
memory impairment was the primary source of her
problems in realising voice onset time in phoneme
blending. According to their interpretation, the
phonetic realisation of voice onset time requires the
temporal coordination of independent articulatory
gestures, and is thus more sensitive to memory loss
than any other phonetic feature. Our patient, OE,
produced voicing errors (as well as other single feature errors) only when the reverse operation to
blending—i.e. segmentation—was involved. As in
LR’s case, we attributed the occurrence of single
feature errors to a memory impairment that was exacerbated only when the task required segmentation and temporary holding of sound information.
Importantly, the spectral analysis of OE’s voice onset time production in word reading aloud (a task
which did not tax OE’s working phonological
memory), revealed no deficit in reading aloud. As
this type of spectral analysis was not conducted in
Berndt and Mitchum’s study, we are unable to draw
a direct comparison of the effects of memory impairment in regard to blending and segmentation
operations. However, we find it interesting that
both LR’s and OE’s memory impairment affected
voicing cognates. In the case of OE, the phonological memory impairment not only affected the processing of voicing cognates but also round,
continuant, and nasal cognates. According to a re-
PHONOLOGICAL SPELLING IN A DAT PATIENT
cent model of phonology (e.g. Paradis, 1993), these
features share a common characteristic in that they
are all “terminal features”, i.e. features which are located at the same level in the feature geometry. In
OEs case, those terminal features may be more sensitive to memory loss in the feature geometry. In
OE’s case, those terminal features may be more
sensitive to memory loss because of their special status in the phonological hierarchy rather than the
complexity of their phonetic realisation, as suggested by Berndt and Mitchum (1994) in the case of
LR.
In OE’s case, voicing errors account for the
highest proportion of single feature errors produced
in written spelling (103 voicing errors out of 187
single feature errors). Voicing errors thus play the
largest role in the dissociation between written and
oral spelling. For the three remaining features, although there are more errors overall in written
spelling than in oral spelling, the low frequency of
these errors does not allow us to draw firm conclusions about OE’s incapacity to handle these features
in the phonological working memory. The possibility that these three features are randomly substituted is more difficult to rule out.
An important characteristic of OE’s performance in spelling is the presence of a significant
phonological complexity effect in both oral and
written spelling. Shallice (1981) has suggested
that the nonlexical route for writing involves at
least two stages: (1) the segmentation of the string
into phonemes (or possibly groups of phonemes);
and (2) transformation of these units into a
graphemic form. Shallice reported that his patient, PR, had problems with the two processes in
writing nonsense syllables. OE, who used the
nonlexical route for spelling both words and
nonwords, also experienced problems with these
two processes. Sensitivity to the syllabic structure
complexity of the stimuli indicates that OE had
difficulty in the segmentation of the phonemic
string and that, at least in the case of the French
language, this segmentation involves syllable
units. The problems OE had with the second process, i.e. the transformation of units into
graphemic units, cannot be ruled out because he
produced a number of nonphonologically princi-
pled NPPEs (e.g. soulever /sulve/ ‘to lift up’ ®
“goulever”) for which we have no explanation.
OE’s spelling performance was also characterised by the presence of “phonological repairs”, that
is, spelling errors that contained feature, vowel, or
consonant insertions that reduced the syllable complexity at a phonological level (e.g., poète /poet/
“polète”). Shallice (1981) investigated the possibility that a phonological impairment affecting speech
output would affect writing performance. His patient, PR, who suffered from a very mild conduction aphasia, produced spelling errors only in
writing nonsense syllables. We reanalysed the reported errors and found no errors that could be construed as phonological repairs. Kohn (1989) also
investigated a conduction aphasic patient in order
to see if speech output phonological disturbance
would affect writing performance. Unfortunately,
she tested only 30 stimuli on which the patient produced only 8 errors, of which 4 were reported. Only
one error could be interpreted as a phonological repair: pumpkin ® “punkin” (replacement of the labial consonant by a dental resulting in a less marked
heterosyllabic cluster).
CONCLUSION
In conclusion, OE suffers from impaired access to
the orthographic output lexicon. He uses the
nonlexical route in oral and written spelling. Impairment of the phoneme-to-grapheme conversion
mechanism’s subsystem is responsible for a phonological complexity effect found in both oral and
written spelling. More specifically, OE produces
more NPPEs than PPEs on phonologically complex stimuli. His deficit is limited to the explicit
segmentation of the sound form since the implicit
segmentation as involved in the acoustic analysis in
repetition and reading aloud is unimpaired. OE
also shows a deficit in the phoneme-to-grapheme
conversion (the other subsystem of the phoneme-to-grapheme conversion mechanism),
which is less severe than the deficit affecting the explicit segmentation procedure. A deficit affecting
the phonological working memory system is responsible for the production of single feature errors
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
147
BÉLAND, BOIS, SERON, DAMIEN
produced in both oral and written spelling. These
single feature errors are more abundant in written
spelling because a deficit in the transfer from the
graphemic buffer to the allographic conversion
slows down the writing process. In order to refresh
the trace in the graphemic buffer, OE is forced to
reconvert the sound form into spelling correspondences. This reconversion is itself reliant on the
15
trace held in the phonological buffer , which decays rapidly because of the partially impaired phonological working memory system. Oral spelling is
less taxing for the phonological working memory;
no reconversion is required because the transfer
from the graphemic buffer to the letter name conversion is only mildly impaired.
Another solution that would account for the
higher rate of single feature errors in written spelling would posit that the deficit affects the
allographic conversion mechanism itself (rather
than the transfer to it), which would have a different
organisation in OE’s case. Given that OE was a
poor speller in childhood, the letters in the
allographic conversion might have been encoded
with respect to their sound correspondences. For
instance, one could imagine that the allographic
conversion of the abstract graphemic representation for P is stored close to the conversion for the
letter B. Such a classification may not be needed in
the case of letter names conversion because most of
the letter names in French are more tightly associated to their sound correspondence (e.g. the letter
name for B, /be/, includes the sound /b/).
This highly speculative proposal would not,
however, account for OE’s single feature errors that
occurred in other tasks such as delayed nonword
repetition, rhyme judgement in the auditory modality, and auditory to written nonword matching.
This proposal allows us to localise the deficit into a
subcomponent rather than into the transfer between two components, but it does not allow us to
make the economy of an impairment to the phonological working memory system. Further investigations of phonological spellers with a history of
premorbid dysorthographia without impairment to
15
the phonological working memory might confirm
that a disorder in spelling acquisition may result in a
different functioning of the allographic conversion
mechanism. That is, the allographic conversion
mechanism of poor spellers would be sensitive to
the letter-sound correspondences in addition to the
letter visual shapes.
This case study confirms that the phonemeto-grapheme conversion mechanism is a complex
system that contains at least two subsystems: the
segmentation and the conversion subsystems.
Either of these subsystems may be disrupted independently, or, as in the case of OE, both may be impaired. When the segmentation subsystem is more
severely impaired than the phoneme-to-grapheme
mapping subsystem, it results in a phonological
complexity effect in the nonlexical route for spelling, as in this case study.
Manuscript received 6 January 1996
Revised manuscript received 15 May 1998
Manuscript accepted 20 June 1998
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PHONOLOGICAL SPELLING IN A DAT PATIENT
APPENDIX A
Scores for Linguistic Tests of the MT-86 b Aphasia Battery
Linguistic Subtests (Perfect Scores)
Controls
——————————————
M
SD
Cut-off
July
1993
Interview (100)
Automatised sequences (3)
Word and sentence picture-matching (47)
Object manipulation (8)
Written word and written sentence picture-matching (13)
Reading comprehension of a text (100)
Repetition (30)
Reading a text aloud
Dictation (37)
Copy (13)
Naming (31)
Written picture naming (12)
Verbal fluency
Oral picture description (18)
Written picture description (18)
Number repetition (10)
Number oral reading (10)
Reading aloud (30)
Signature (1)
Buccofacial praxis verbal requests (6)
Buccofacial praxis imitation (6)
Body-part identification oral request (8)
Body part identification written request (8)
Written questionnaire (7)
99.44
2.95
45.25
7.77
12.51
87.49
28.88
1.33
34.47
12.69
30.27
11.13
24.69
14.54
14.23
9.93
9.92
29.30
1
5.77
5.87
7.97
7.97
6.77
100
3
42
5
12
83.3
27
0
16
12
14
5
1
8
10
10
7
27
1
3
6
5
6
7
2.19
0.22
2.01
0.43
0.91
16.20
1.11
3.22
4.18
0.95
0.97
1.00
6.20
2.27
2.45
0.25
0.27
1.48
0.48
0.34
0.16
0.16
0.43
40
6
9
24
22
8
28
8
15
9
9
26
4
4
5
APPENDIX B
List of the 13 Different Types of Complex Context and Their Distribution in the 277
Phonologically Complex Stimuli
1. A consonant cluster in an onset syllabic position (e.g. prison /prizO
~ / ‘jail’; déclin /deklE~/ ‘decline’; 20 stimuli).
2. A word-initial syllable with an empty onset (e.g., ajout /aZu/ ‘addition’; 15 stimuli).
3. A hiatus context created by the adjacency of two vowels, each of which belongs to a separate syllable (e.g. géant /Zea~ / ‘giant’;
33 stimuli).
4. A word comprising a syllable with a rising sonority diphthong (e.g. depuis /dœpèi/ ‘since’; 40 stimuli).
5. A final syllable comprising a glide in a simple coda position (e.g. bétail /betaj/ ‘cattle’; 34 stimuli).
6. A syllable comprising a glide onset (e.g. mouillé /muje/ ‘wet’; 19 stimuli).
7. A word comprising two ligth diphthongs separated by an obstruent onset (e.g. moitié /mwatje/ ‘half ’; 14 stimuli).
8. A syllable comprising a light diphthong followed by a glide onset (e.g. joyeux /Zwajø/ ‘happy’; 14 stimuli).
9. A heterosyllabic consonant cluster (e.g. partie /parti/ ‘game’; 20 stimuli).
10. A word with a schwa, i.e. a mute E (e.g. matelas /matlA/ ‘mattress’; 28 stimuli) (see footnote 12).
11. A word comprising two nondental consonants (e.g. café /kafe/ ‘coffee’; 18 stimuli.
12. A word comprising two identical consonants (e.g. dindon /dE
~ dO
~/ ‘turkey’; 12 stimuli.
13. A word comprising two consonants sharing the same place of articulation (e.g. méfait /mefE/ ‘damage’ in which /m/ and /f/
are both labial consonants; 10 stimuli).
COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
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BÉLAND, BOIS, SERON, DAMIEN
APPENDIX C
Examples of Responses
Examples of Phonologically Plausible Errors (PPEs) in Written Spelling (WS) and Oral Spelling (OS)
Phonologically simple stimuli
cinéma /sinema/ ‘cinema’ ® sinémat (OS)
lingot /lE
~ go/ ‘ingot’ ® lingau (WS)
maçon /masO
~ / ‘builder’ ® masson (WS)
panneau /pano/ ‘panel’ ® panot (OS)
Phonologically complex
beignet /bE®E/ ‘doughnut’ ® baignet (OS)
maïs /mais/ ‘corn’ ® mahisse (WS)
paletot /palto/ ‘cardigan’ ® paltau (OS)
printemps /prE
~ tã/ ‘spring’ ® printent (WS)
Examples of Sound-to-Spelling Correspondences in PPEs in WS and OS
Sound-to-spelling correspondences for the sound /o/:
boléro /bOlero/ ‘bolero’ ® polero (WS)
judo /Z Ydo / ‘judo’ ® judeau (WS)
judo /Z Yd o/ ‘judo’ ® judot (WS)
lingot /lE
~ g o/ ‘ingot’ ® lingaut (OS)
Sound-to-spelling correspondences for the sound /A/:
mandat /mãdA/ ‘mandate’ ® mandeat (WS)
tuba /tY bA/ ® tubat (WS and OS)
Sound-to-spelling correspondences for the sound /E
~/:
daim /dE
~/ ‘deer’ ® dein (OS)
gain /gE
~/ ‘winning’ ® gaint (WS)
gain /gE
~/ ‘winning’ ® guin (OS)
requin /rœkE
~/ ‘shark’ ® requint (WS)
Sound-to-spelling correspondences for the sound /A
~/:
gens /ZA
~ / ‘people’ ® geant (OS)
lent /lA
~ / ‘slow’ ® lant (WS)
rang /rA
~ / ‘rank’ ® rent (WS)
sans /sA
~ / ‘without’ ® san (OS)
Sound-to-spelling correspondences for the sound /Y/:
jury /ZYr i / ‘jury’ ® guri (WS)
repu /repY / ‘satiated’ ® repue (WS)
repu /repY / ‘satiated’ ® reput (OS)
Examples of Phonological Repairs in WS and OS in Phonologically Complex Stimuli
VXV Empty onset between two rimes
Segment preservation
pays /pEi/ ‘country’ ® pailis (WS)
poète /pOEt/ ‘poet’ ® polète (OS)
Segment deletion
échéant /eSeA
~ / ‘if need be’ ® échan (OS)
koala /koala/ ‘koala’ ® cola (OS)
C$C heterosyllabic consonant cluster
Segment preservation
toxique /tOsik/ ‘toxic’ ® torsif (WS)
toxique /tOksik/ ‘toxic’ ® tosris (OS)
Segment deletion
Égypte /eZipt ‘Egypt’ ® échippe (WS)
Égypte /eZipt ‘Egypt’ ® égit (WS)
Word-initial glide
Segment preservation
yéti /jeti/ ‘toxic’ ® geti (WS)
yoga /joga/ ‘yoga’ ® jogat (OS)
Segment deletion
yéti /jeti/ ‘Yeti’ ® étit (OS)
yoga /joga/ ‘yoga’ ® ogot (OS)
Word-final glide
Segment preservation
bouille /buj/ ‘boil’ ® boule (OS)
vanille /vanij/ ‘vanilla’ ® vanine (WS)
Segment deletion
fenouil /fûnuj/ ‘fennel’ ® fenoue (OS)
quille /kij/ ‘keel’ ® quie (WS)
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COGNITIVE NEUROPSYCHOLOGY, 1999, 16 (2)
PHONOLOGICAL SPELLING IN A DAT PATIENT
Rising sonority diphthong
Segment preservation
juin /Zèû
~ / ‘June’ ® choin (OS)
mouette /mwEt/ ‘gull’ ® mouellet (WS)
Segment deletion
mielleux /mjElï / ‘syrupy’ ® milleu (OS)
ruisseau /rè iso/ ‘stream’ ® russon (WS)
Rising sonority diphthong + glide + vowel
Segment preservation
joyeaux /Zwajø/ ‘joyous’ ® choiseux (WS)
loyer /lwaje / ‘rent’ ® loiser (OS)
Segment deletion
cuiller /kè ijEr/ ‘spoon’ ® queer (WS)
joyau /Zwajo/ ‘jewel’ ® vouhou (OS)
Examples of Miscellaneous Errors in WS and OS
Omission errors
/koidA
~ / (non-word) ® ohidant (WS)
rouquin /rukE
~ /redhead’ ® rouqun (OS)
taxi /taksi / ‘taxi’ ® tax (OS)
Addition errors
fuite / fèit/ ‘flight’ ® fruite (WS)
Moïse /moiz/ ‘Moses’ ® moeise (OS)
pilori /pilo ri/ ‘pillory’ ® pililri (OS)
roue /ru/ ‘wheel’ ® rouet (WS)
/vais/ (non-word) ® vaivse (OS)
Substitution errors
chandail /SA
~ daj/ ‘sweater’ ® chandeil (OS)
/dabe/ (non-word) ® dabi (OS)
libido /libido/ ‘libido’ ® libider (OS)
quenouille /kûnuj/ ® canouille (WS)
soulever /sulve/ ‘to lift’ ® goulever (WS)
Complex errors
/f A
~Si/ (non-word) ® pranchi (WS)
/gYba/ (non-word) ® buda (OS)
navet /navE/ ‘turnip’ ® manet (WS)
toucan /tukA
~ / ‘toucan’ ® tougert (OS)
Examples of Tortuous Spellings in WS and OS
Phonologically simple stimuli
côte /kote/ ‘side’ ® cotet (WS)
jury /ZYri/ ‘jury’ ® guri (WS)
menu /mûnY/ ‘menu’ ® meneu (OS)
vaisseau /vEso/ ‘vessel’ ® vaiseau (OS)
Phonologically complex stimuli
bahut /baY/ ‘chest’ ® baheu (WS)
coquin /kokE
~ / ‘mischievous’ ® cochin (WS)
flairer /flEre/ ‘to smell’/ ® fllré (OS)
pelleter /pElte/ ‘to shovel’/ ® pelt (OS)
vaillant /vajã/ brave ® vaien (OS)
Nonword
/zade/ ® zadet
Examples of French Accent Errors in WS and OS
menu /mûnY/ ‘menu’ ® ménu (WS)
pédalo /pedalo/ ‘pedalo’® pedalot (OS)
séchoir /seSwar/ ‘drier’ ® sechoir (OS)
têtu /tEty / ‘stubborn’ ® tetu (OS)
vélo /velo/ ‘bike’ ® velo (OS)
Examples Affecting the Four Phonological Features in Written Spelling
Phonologically simple stimuli
[+ voiced] ® [– voiced]
vanité /vanite/ ‘vanity’ ® fanider
[– voiced] ® [+ voiced]
futé /fYte/ ‘crafty’ ® fuder
safari /safari/ ‘safari’ ® savari
[+ nasal] ® [– nasal]
gant /gã/ ‘glove’ ® gat
[– nasal] ® [+ nasal]
bateau /bato/ ‘boat’ ® baton
boni /boni/ ‘profit’ ® moni
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BÉLAND, BOIS, SERON, DAMIEN
[+ rounded] ® [– rounded]
rigolo /rigolo / ‘funny’ ® rigalot
[– rounded] ® [+ rounded]
faisan /fûzA
~ / ‘pheasant’ ® faison
Phonologically complex stimuli
[+ voiced] ® [– voiced]
féodal /feodal/ ‘feudal’ ® féotalle
juin /ZèE
~/ ‘June’ ® choin
[– voiced] ® [+ voiced]
fauteuil /fotûj/ ‘armchair’ ® faudeuil
koala /koala/ ‘koala’ ® goalat
[+ nasal] ® [– nasal]
chuinter /SèE
~ te/ ‘screech’ ® choiter
denteler /dA
~ tle / ‘jagged’ dédeler
[– nasal] ® [+ nasal]
ruisseau /rèiso/ ‘stream’ ® russon
[+ rounded] ® [– rounded]
corail /koraj/ ‘coral’ ® garail
rodéo /rodeo/ ‘rodeo’ ® rodeal
[– rounded] ® [+ rounded]
safran /safrA
~ / ‘saffron’ ® safron
[+ continuant] ® [– continuant]
ferraille /feraj/ ‘old iron’ ® pérail
Nonwords
[+ voiced® [– voiced]
/gabY/ ® gapu
/zade/ ® sadé
[– voiced] ® [+ voiced]
/baSi/ ® bagi
/nopi/ ® nobie
[+ continuant] ® [– continuant]
/veva/ ® veba
Examples Affecting the Four Phonological Features in Oral Spelling
Phonologically simple stimuli
[+ voiced] ® [– voiced]
bassin /basE
~/ ‘pond’ ® passin
[+ nasal] ® [– nasal]
canon /kanO
~/ ‘canon’ ® cano
[– nasal] ® [+ nasal]
pédant /pedA
~ / ‘pedanatic’ ® medan
[+ rounded] ® [– rounded]
colis /koli/ ‘parcel’ ® callis
[– rounded] ® [+ rounded]
marina /marina/ ‘marina’ ® marineau
Phonologically complex stimuli
[+ voiced] ® [– voiced]
tordu /tOrdY/ ‘twisted’ ® tortu
[– voiced] ® [+ voiced]
café /kafe/ ‘coffee’ ® gafé
[+ nasal] ® [– nasal]
chignon /Si®O~ / ‘bun’ ® ginau
[– nasal] ® [+ nasal]
ruisseau /rèiso/ ‘stream’ ® ruisson
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PHONOLOGICAL SPELLING IN A DAT PATIENT
chuinter /SèE
~ te/ ‘screech’ ® choiter
[+ rounded] ® [– rounded]
patois /patwa/ ‘dialect’® patai
Nonwords
[– voiced] ® [+ voiced]
/bikA
~ / ® bigon
[+ nasal] ® [– nasal]
/fA
~ S i/ ® fachi
[– rounded] ® [+ rounded]
/dupA
~ / ® doupont
Patient’s Responses in Written Spelling Which Contain Letter Sequences (Underlined) Which are Illicit in French Orthography
bibelot /biblo/ ‘bibelot’ ® bibeaut
bouille /buj/ ‘boil’ ® bouiler
bouilloire /bujwar/ ‘kettle’ ® boueil
chatouille /Satuj / ‘tickle’ ® pachauil
coyote /kOjOt/ ‘coyote’ ® qaquod
douille /duj/ ‘cartridge’ ® doutle
douillet /dujE/ ‘cosy’ ® couhillet
examen /EgzamE~ / ‘examination’ ® éxamen
javelot /Zavlo/ ‘javelin’ ® gahelot
joyau /Zwajo/ ‘gem’ ® joieu
juillet /Zèije/ ‘July’ ® jehuin
jumeler /ZYmle / ‘to twin’ ® qumeler
mayonnaise /m ajOnEz/ ‘mayonnaise’ ® maihauneise
mouillé /muje/ ‘wet’ ® mouiler
sergent /sErZA
~ / ‘sergeant’ ® sergen
soyeux /swajï/ ‘silky’ ® soieu
système /sistEm/ ‘system’ ® sistemp
voyelle /vwajEl/ ‘vowel’ ® voiieil
voyou /vwaju/ ‘garnement’ ® baheaut
yogourt /jogur/ ‘yogourt’ ® quoqourt
APPENDIX D
Scores on the Semantic Categorisation test
Description
Score
Matching real object with picture of object
Matching colour picture with black and white picture of same object
Categorisation: various pictures of the same concept
Categorisation: pictures of objects/pictures of actions
Grouping pictures together according to semantic category: there is no semantic relationship between groups
Grouping pictures together according to semantic category: there is a close semantic relationship between groups
Categorisation of various pictures: different parts linked to a whole
Categorisation of various pictures: complementary–relatedness
10/10
10/10
9/9
18/18
20/20
20/20
16/16
12/12
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